OBJECTIVES Human Epididymis Protein 4(HE4) is diagnostic test that diagnosis ovarian cacner with CA125 for pelvic mass patients or monitoring of response to treatment, prognosis and reccurence for ovarian cancer patients. So We assess the safety and efficacy of HE4 test METHODS We searched eight domestic databases and other foreign databases such as Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. The 44 articles were included in this review. Two reviewers independently assessed selection of studies and quality assessment of each study. Quality assessment tool was used SIGN. The meta analysis results reported pooled sensitivity and specificity. RESULTS SAFETY : HE4 was conducted with patient’s serum sample, so safety is same as a blood sampling. Thererfore, there is no safety problem. EFFICACY : 1)HE4 vs CA125 : In 10studies, the pooled sensitivity and specificity were HE4 0.771, 0.931 and CA125 0.839, 0.677. 6 studies with suspected ovarian cancer were included, pooled sensitivity and specificity were HE4 0.745, 0.946, CA125 0.819, 0.676. In two studies, hazard ratio of progression-free survival and overall survival for HE4 were higher than CA125. 2) ROMA vs CA125: In 6studies, the pooled sensitivity and specificity were ROMA 0.865, 0.809 and CA125 0.843, 0.672. Three studies with suspected ovarian cancer were included, pooled sensitivity and specificity were ROMA 0.833, 0.857, CA125 0.817, 0.664. In one study, hazard ratio of progression-free survival and overall survival for ROMA were higher than CA125. CONCLUSIONS Although sensitivity of HE4 was lower than CA125, but specificity was higher than CA125. So HE4 supplemented lower specificity of CA125. Beause sensitivity and specificity of ROMA were highter than CA125, lower sensitivity of HE4 were supplement with CA125. Also prognostic value of this test looks like it can be used to predict recurrence in patients diagonised with epithelial ovarian cancer, it’s hard to generalize it will current research outcomes.