<p>Frozen section remains the most reliable method used for provisional intraoperative diagnosis of ovarian cancer, despite various imaging modalities. Its results enable the surgeon in decision-making between a fertility-sparing or an extended surgery. The study aims to calculate the diagnostic accuracy of frozen section in patients with ovarian masses, also, to calculate the sensitivity, specificity, NPV, and PPV of intraoperative frozen section for benign, borderline, and malignant ovarian masses, considering histopathology as the gold standard. The retrospective study was conducted at a tertiary care center in India. Patients who underwent surgery for ovarian masses followed by frozen section (FS) were studied. Study data of 185 patients Jan 2020 to June 2024 was obtained from the hospital computerized database. Data collected included basic and clinical characteristics. Patients with a diagnosis of ovarian tumors by clinical examination or imaging with consultation for intraoperative ovarian tumors frozen section were included in the study, and cases of incomplete medical records were excluded. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of intraoperative frozen and permanent sections were evaluated. A significant agreement was seen between FS and final histopathology with a kappa value of 0.899 and <i>P</i>-value &lt; 0.001. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for benign were 98.4%, 98.9%, 97.8%, 97.8%, and 98.9%; for borderline, they were 94%, 85.7%, 95%, 69.2%, and 98.1%; and for malignant pathology, they were 95.6%, 90.3%, 99.1%, 98.5%, and 94.0% respectively. Our study concludes that the utility of intraoperative FS analysis is an excellent tool in the management of ovarian masses. Thus, FS, by providing nearly accurate diagnosis, facilitates informed surgical decision-making and thereby improves patient care outcomes.</p>