Objectives: To study the incidence and trends of non-epithelial ovarian cancer (OC) in the United States as compared to Asia. Methods: Data were obtained from the United States Cancer Statistics (USCS) Public Use Databases and the Taiwan Cancer Registry of Taiwan Health and Welfare Data Center (HWDC) from 2001 to 2017. SEER*Stat 8.3.9, Joinpoint regression program 4.8.0.1, and Excel were used to calculate the incidence and trends. Results: From 2001 to 2017, the incidence of germ cell and sex cord-stromal tumors in the US was 0.42 and 0.26 per 100,000, while In Asia, the incidence was 0.74 and 0.33 per 100,000, respectively. While the average annual percent change (AAPC) has been increasing for non-epithelial OC in both the US and Asia, the increase is markedly greater in Asia. In Asia, the incidence is increasing at three times the rate for sex cord-stromal tumors (1.7 vs 5.7 AAPC) and at nearly 5.5 times the rate for germ cell tumors (0.3 vs 1.6 AAPC), compared to the US. For germ cell tumors, the peak age incidence is younger in the US versus Asia (20-24 years vs 25-29 years, respectively). While for sex cord-stromal tumors, the peak age incidence is older in the US versus Asia (65-69 years vs 50-54 years, respectively). Conclusions: The overall incidence of germ cell and sex cord-stromal OCs is increasing in both the US and Asia. However, it is approximately 50 percent higher in Asia as compared to the US. Further investigation should investigate the role that genetic and environmental factors play in explaining these trends. [ABSTRACT FROM AUTHOR]