The object of this study was to clarify the association between microvessel density and clinicopathologic factors, as well as the association of angiogenic factors (vascular endothelial growth factor [VEGF] and transforming growth factor-β [TGF-β]) with tumor angiogenesis and patient survival in epithelial ovarian cancer. The expression of VEGF and TGF-β was evaluated by immunohistochemical staining in 60 patients with epithelial ovarian cancer. The microvessel density, assessed by immunostaining for factor VIII-related antigen in the most neovascularized areas, varied depending on histological types but not on International Federation of Gynecology and Obstetrics stage. Patients with stage III carcinomas and positive TGF-β had more extensive peritoneal dissemination and a worse outcome. The microvessel density of VEGF-rich and TGF-β positive tumors was significantly higher than that of VEGF-poor and TGF-β negative tumors. Angiogenesis appears to be an early event in epithelial ovarian cancer and may be induced differently in tumors of different histological types. The expression of VEGF and TGF-β associates with the promotion of angiogenesis, and the expression of TGF-β is a prognostic indicator in epithelial ovarian cancers.