Objective Exploring the effects of prognostic nutritional index PNI and control nutritional score CONUT on chemotherapy response and survival in ovarian cancer patients undergoing chemotherapy. Method A prospective study was conducted on 160 ovarian cancer patients who were treated at Wuhan Third Hospital from January 2017 to December 2017 and followed up until December 2022. Based on the cut-off value of moderate to severe malnutrition of CONUT and PNI patients were divided into low CONUT group CONUT<5 n = 74 and high CONUT group CONUT ≥ 5 n = 86 according to the CONUT score. Patients were divided into a low PNI group PNI<40 n = 78 and a high PNI group PNI ≥40 n = 82 based on PNI. Collect the overall survival OS of patients in different groups evaluate the overall survival of patients using Kaplan Meier curve based on their prognosis and analyze the relationship between CONUT PNI and OS. Compare the adverse reactions of different CONUT and PNI chemotherapy. Result The median follow - up time of 160 ovarian cancer chemotherapy patients was 33 months the 95% CI was 33. 694 36. 694 with a total of 99 patients 61. 88% reaching the follow-up endpoint. The median OS of patients in the low CONUT vs. high CONUT group was 45 months versus 27 months χ 2 = 50. 283 P<0. 05 respectively median OS for PNI <40 and PNI 40 was 27 months and 44 months respectively χ 2 = 9. 286 P<0. 05 . Patients with CONUT 5 or PNI <40 had lower overall survival than those with CONUT <5 and PNI 40. Cox regression showed that clinical stage CA125 NLR PLR and LMR were all independent factors affecting OS in ovarian cancer patients with different CONUT and PNI levels P < 0. 05 . The incidence of leukopenia thrombocytopenia nausea vomiting and diarrhea was higher in patients with low CONUT P<0. 05 . The incidence of nausea vomiting and diarrhea was higher in the low PNI group than in the PNI group P<0. 05 . Conclusion CONUT and PNI affect the OS of ovarian cancer patients with chemotherapy and the adverse effects of CONUT and PNI patients are inconsistent it can be seen that the association between nutritional status and the short-term and long-term prognosis of ovarian cancer chemotherapy patients is significant which can be used as an effective indicator to predict the chemotherapy response and prognosis of patients.