Objective: The objective of this study was to determine if use of menopausal hormones was associated with ovarian cancer and if risk varied by type of hormone used. Study design: Data from a population-based, case-control study of ovarian cancer in North Carolina (364 cases, 370 controls, all postmenopausal) were analyzed to evaluate the relationship between menopausal hormones and ovarian cancer. logistic regression analyses were used to calculate odds ratios (OR) and 95% CIs associated with various patterns of hormone use. Results: Ovarian cancer cases were more likely than controls to report long-term use (≥ 10 years) of unopposed estrogens (OR 2.2; 95% CI 1.2-4.1). No relationship was observed for estrogen always used with progestin. Conclusion: Hormone replacement therapy used according to current recommendations should not increase risk of ovarian cancer; however, clinicians should be aware of possible increased risk among women with a long history of estrogen replacement therapy. Objective: The objective of this study was to determine if use of menopausal hormones was associated with ovarian cancer and if risk varied by type of hormone used. Study design: Data from a population-based, case-control study of ovarian cancer in North Carolina (364 cases, 370 controls, all postmenopausal) were analyzed to evaluate the relationship between menopausal hormones and ovarian cancer. Logistic regression analyzes were used to calculate odds ratios (OR) and 95% CIs associated with various patterns of hormone use. Results: Ovarian cancer cases were more likely than controls to report long-term use (≥ 10 years) of unopposed estrogens (OR 2.2; 95% CI 1.2-4.1). No relationship was observed for estrogen always used with progestin. according to current recommendations should not increase risk of ovarian cancer; however, clinicians should be aware of possible increased risk risk among women with a long history of estrogen replacement thera py.