OBJECTIVES: To evaluate whether the use of bevacizumab in first line treatment for patients with advanced ovarian cancer represents a cost-effective strategy for health institutions in Mexico. METHODS: Ovarian Cancer is the sixth most common cancer and second gynecologic malignancy worldwide, with approximately 190,000 new cases per year. Ovarian cancer is considered highly lethal for their growth characteristics, low symptoms and recurrence.  A complete economic evaluation of cost-effectiveness was performed in women with ovarian cancer stage III and IV, classified as high risk, taking carboplatin + paclitaxel (CP) and bevacizumab+ carboplatin +paclitaxel (BCP) as comparators. The 1st cycle, carboplatin + paclitaxel are administered alone; from 2nd to 6th is added bevacizumab (7.5 mg / kg). From cycle 7, all patients with no evidence of disease progression received maintenance bevacizumab as monotherapy, giving a maximum of 18 cycles. The progression was emulated with a Markov model considering the stages of: progression free survival, progression and death in a 11.5 year time horizon. Costs are expressed in US dollars. RESULTS: BCP gained more months with progression free survival compared with CP (16.77 vs. 14.40). BCP obtained 40.89 months of overall survival versus 31.17 with CP, generating a 36% increase in overall life expectancy. The Incremental Cost Effectiveness Ratio (ICER) for BCP is $25,544 per year of additional life year gained with respect the use of CP. According to the International Monetary Fund, the Gross Domestic Product (GDP) for Mexico in 2011 was $9471. For a threshold of 3 times this value (3 GDP per capita: $28,413), the use of BCP in advanced ovarian cancer would be cost-effective. CONCLUSIONS: BCP is an alternative that substantially increases the patient overall survival expectancy. It also lies within the international cost-effectiveness threshold.