Objective: To compare the diagnostic value of Magnetic resonance imaging (MRI) and Computed tomography (CT) in ovarian cystic lesions. Methods: From May 2021 to June 2024, the clinical data of 76 patients who were diagnosed with ovarian cystic lesions by surgical pathology were retrospectively collected. Surgical pathologic diagnosis is the gold standard for tumor diagnosis. MRI and CT were performed in all patients to analyze and compare the diagnostic value of MRI and CT in ovarian cystic lesions. Results: Among 76 cases of ovarian cystic solid lesions, 23 cases of cystadenoma, 8 cases of cystadenocarcinoma, 19 cases of teratoma, 5 cases of simple cyst and 21 cases of endometriosis cyst. There were 54 benign cases (71.05 %) and 22 malignant cases (28.95 %). The rate of cyst wall rule in MRI and CT of benign mass was higher than that of malignant mass (P < 0.05), and the rate of cyst wall nodule and abdominal fluid accumulation were lower than that of malignant mass (P < 0.05). The accurate number of benign and malignant masses diagnosed by MRI was 14.29% (6/42) and 26.67% (4/15) higher than that diagnosed by CT, respectively. Overall, the diagnostic accuracy of MRI was 88.16% (67/76), higher than that of CT (75.00) (57/76, χ2=4.378, P < 0.05). Conclusion: MRI is more effective than CT in the diagnosis of ovarian cystic lesions, which is worthy of clinical application.