【Objective】To investigate the efficacy of neoadjuvant chemotherapy for ovarian cancer and explore the feasibility of hydrogel embedded histoculture drug sensitivity test （HDST）use in selecting chemotherapy regiments for ovarian cancer.【Methods】We performed a retrospective analysis of 11 patients with advanced ovarian cancer treated with neoadjuvant chemotherapy as recommended by NCCN guidelines at the department of gynaecological oncology in Sun Yat- sen Memorial Hospital. Demographics，clinical data and tissue specimens were collected from patient charts. The patients were grouped according to the HDST results. We compared the differences between groups in the total decline rate of CA125，HE4 and Fagotti scores and analyzed their relationship with HDST results.【Results】HDST results showed that 6 patients were not sensitive to the selected platinum drugs（cisplatin or carboplatin）and 1 patient not sensitive to paclitaxel. After 3 times of neoadjuvant chemotherapy ，the patients presented a significantly successive decrease in the levels of tumor markers. HDST results were consistent with the clinical efficacy（Kappa=1.000，P<0.05），with 100% sensitivity，100% specificity and 100% Youden′s index. There was a significant positive correlation between changes in Fagotti′ sscores and effective rate of HDST（rs=0.678，P<0.05），while no correlation between the total decline rate of CA125 and HE4 and effective rate of HDST（P>0.05）.【Conclusions】HDST is fast ，convenient and economical in helping select neoadjuvant chemotherapy for ovarian cancer. Additionally，with its consistency with the clinical efficacy，HDST is expected to provide an accurate individualized chemotherapy for patients with ovarian cancer.