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Background: Patients with advanced high-grade serous ovarian cancer (HGSOC) have a poor prognosis. Hence there have been attempts to find prognostic markers to identify patients with higher risk of relapse. Radiomic features have been proved as an emerging tool in different neoplasms. However, in ovarian cancer very few studies have investigated the role of metabolic parameters at diagnosis. The aim of our work was to assess the prognostic value of pretreatment 18F-FDG PET/CT quantitative metabolic parameters in patients with advanced high-grade serous ovarian cancer. A review of 47 patients diagnosed of advanced high grade serous ovarian cancer between 2016 and 2020 in our center was performed, evaluating pretreatment 18F-FDG-PET/CT metabolic parameters: maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and metabolic tumoral volume (MTV). The images were evaluated and quantitative parameters were obtained semiautomatically classifying VOIs as target, non target and total according to SULmax. Clinical data of relapse/progression and final status (exitus/alive) was collected. Disease-free survival (DFS) and overall survival (OS) were calculated. Optimal cutoff values with receiver operating characteristic curve/median values were used. Correlation between metabolic parameters and DFS/OS was made using univariate and survival-curves analysis. Results: Median DFS was 18 months (2.55-55) and OS 33.6 months (2.5-92). MTV total, MTV target, TLG total and TLG target were significantly associated with DFS (p 0.005, 0.011, 0.046 and 0.042 respectively). The survival-curves analysis showed a significant difference of DSF in patients with MTV total >427.8 cm3 and MTV target >434 cm3 versus patients with lower values (18.8 and 15.6 months vs 31 and 30 months, p 0.027 and 0.017 respectively). Patients with higher TLG total and TLG target values tended to have worse DSF, although not statistically significant (p 0.263 and 0.317, respectively). None correlation was found with OS. Conclusion: Pretreatment metabolic parameters MTV total and MTV target have prognostic value in patients with high-grade advanced serous ovarian cancer, being able to predict higher risk of relapse.