Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle pre- and post-diagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self-reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n=678) and after completing primary treatment (n=512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all-cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95%CI: 0.59-1.04), however the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95%CI: 0.40-0.93; p-trend=0.02). Current smoking, particularly post-diagnosis, was associated with higher mortality (HR 1.68, 95%CI: 1.17-2.42; HR 2.82, 95%CI: 1.29-6.14, for pre- and post-diagnosis smoking respectively), but women who quit after diagnosis had survival outcomes similar to non-smokers (HR 0.99, 95%CI: 0.57-1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95%CI: 0.39-0.92; p-trend 0.02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis. This article is protected by copyright. All rights reserved.