Objective: To investigate the diagnostic accuracy and influencing factors of frozen pathological examination in ovarian borderline tumors. Methods: The clinical data of 253 patients with ovarian borderline tumors admitted to the Department of Gynecology, Affiliated Hospital of Qingdao University from January 2007 to December 2016 were retrospectively analyzed. Results: The intraoperative frozen pathological examination was consistent with the results of postoperative pathological examination in 211 cases (83.40%), while the other 42 cases were inconsistent. Univariate analysis showed that patients with tumor diameter ≥10 cm, CA125 normal level, non-slurry pathological type, FIGO stage I, no peritoneal implantation, or less than 10% of borderline components were associated with pathological inconsistency. Multivariate logistic analysis showed that pathological type was an independent factor for inconsistency between intra- and postoperative pathological diagnosis. Inconsistent pathological results can lead to increased re-surgery (χ²=4.909, P=0.027). Conclusion: Preoperative diagnosis of ovarian borderline tumors is difficult. The intraoperative frozen pathological examination has high sensitivity. The pathological type is an independent influencing factor of pathological inconsistency between intraoperative frozen and postoperative paraffin pathological findings.