Context: Approximately 90% of malignant ovarian tumors arise from the superficial epithelium which is subject to malignant transformation by genetic modifications that disrupt proliferation and apoptosis. Objective: In the present study, VEGF, survivin, and Smac/DIABLO levels were assessed and its prognostic impact content was estimated in patients with serous ovarian carcinoma (SOC). Methods: Quantification of serum protein levels was performed using an ELISA technique. Patient(s): Ninety-two patients with primary SOC were enrolled. Six patients were lost to follow-up (n=86). Intervention(s): Statistical analysis based on serum protein concentrations was carried out. OS as well as DFS was measured. Kaplan-Meier analysis was used to construct OS and DFS curves, next curves were compared by the log-rank test. Main Outcome: Pretreatment VEGF levels ranged from 160.6 to 1611.4 pg/ml. The survivin levels in the SOC patient group were in the range from 56.6 to 188.4 pg/ml, whereas Smac/DIABLO levels were found to be between 56.2 and 328.8 pg/ml. Measure(s): The OS probabilities at 5 years of the high VEGF (21%) and survivin (18%) group, were notably lower than those of the low VEGF (59%; p< 0.001) and survivin (61%; p< 0.001) group. The patients in the low Smac/DIABLO group were characterized by significantly shorter OS than those in the high Smac/DIABLO group (p=0.015). The probabilities of DFS at 5 years in the low VEGF and survivin group were 62 and 63%, while in the high VEGF and survivin group equalled 24 and 22% (p< 0.001). There was also an apparent association between low Smac/DIABLO levels and a reduced DFS (p=0.034). Result(s): Higher serum VEGF/survivin or lower Smac/DIABLO levels corresponded with poor prognosis. Conclusions: Serum measurement of VEGF, survivin, and Smac/DIABLO could be of benefit in the prognosis of patients with SOC.