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OBJECTIVE The study aimed to investigate the prognostic value of the systemic immune-inflammation index (SII) in patients with epithelial ovarian cancer (EOC). METHODS A total of 553 EOC patients were retrospectively analyzed. 250 patients from West China Second University Hospital were assigned into the discovery cohort and 283 patients from The Affiliated Hospital of Southwest Medical University were assigned into the validation cohort. The correlation between SII and survival were analyzed using Cox regression analyses and Kaplan-Meier method. Prediction accuracy was evaluated with the receiver operating characteristics (ROC) curve. RESULTS The high SII (≥612) was correlated with advanced FIGO stage, lymph node metastasis, and tumor recurrence. In univariate Cox regression, patients with high SII (≥612) had a significantly shorter progression-free survival (PFS) and overall survival (OS) compared to low SII patients (<612) in both cohorts. In multivariate Cox regression analysis, SII was an independent prognostic indicator for PFS (HR = 7.61, 95% CI 3.34-17.35, P < 0.001) and OS (HR = 6.36, 95% CI 2.64-15.33, P < 0.001) in the discovery cohort. These results were verified in the validation cohort. CONCLUSION High SII was correlated with poor survival in patients with EOC. The SII was an independent prognostic factor for patients with EOC.