ABSTRACT Objective: To evaluate the effect of lymphadenectomy on clinical outcome in patients with low-grade serous ovarian cancer (LGSOC). Design: Case-control multicenter retrospective study. Setting: University Hospital-based research center. Population: 147 patients with LGSOC. Methods: Propensity score matching (PSM) algorithm was used to balance the basic characteristics of patients with lymphadenectomy or not, and the Kaplan-Meier analysis was used to evaluate the impact of clinical prognosis. Finally, univariate and multivariate Cox proportional hazards regression analysis were performed to analyze the high-risk factors associated with clinical prognosis. Main outcome measures: Disease-free survival (DFS) and overall survival (OS). Results: A total of 147 women from 4 medical centers were enrolled. In the before matching cohort, 101 (68.7%) patients underwent lymphadenectomy. Fifty-two (35.4%) patients experienced recurrence, and 25 (17%) patients died. Kaplan-Meier analysis showed that there was no significant difference in DFS(P=0.058) and OS(P=0.067) in the after matching cohort. Cox proportional hazard regression analysis showed age (P=0.012), the International Federation of Gynecology and Obstetrics (FIGO) stage (P=0.031) and effective cytoreductive surgery (P=0.044) were 3 high-risk factors associated with recurrence. Age (P=0.031) and effective cytoreductive surgery (P=0.009) were 2 high-risk factors associated with death. Conclusions: Lymphadenectomy seems not to provide a significant benefit neither DFS nor OS in our study. Age, the FIGO stage and effective cytoreductive surgery are high-risk factors associated with clinical prognosis in LGSOC patients.