Objective: The aim of this study was to evaluate the role of lymphadenectomy by comparing survival outcomes for patients with clinically early-stage epithelial ovarian cancer (eEOC) who underwent lymphadenectomy versus those who underwent without lymphadenectomy. Methods: We conducted a multi-center retrospective study of patients diagnosed with eEOC by imaging studies (abdominopelvic computed tomography or magnetic resonance imaging) from September 2007 to April 2021. All patients underwent staging operation. Clinicopathological characteristics and oncologic outcomes were compared between the lymphadenectomy group and the no lymphadenectomy group. Primary end point was progression free survival (PFS). Secondary endpoints were overall survival (OS) and perioperative outcomes. Results: During the study period, 586 patients were identified as eEOC on imaging examination, 453 patients (77.3%) had lymphadenectomy and 133 patients (22.7%) did not undergo lymphadenectomy. After surgical staging, the upstaging was 4/133 (3.0%) in the no lymphadenectomy group 28/453 (6.6%) in the lymphadenectomy group; the upstaging by lymph node metastasis was 21/453 (4.6%). Compared to the no lymphadenectomy group , the lymphadenectomy group had a longer median operating time (P = 0.000), a higher estimated blood loss (P = 0.000), and a higher rate of postoperative adverse events (P = 0.004). There was no significant difference in 5-year PFS (88.9% vs 83.4%) and 5-year OS (97.7% vs 97.2%) in the lymphadenectomy group the no lymphadenectomy group, respectively. Among histological subtypes of eEOC, serous ovarian carcinoma showed more improved PFS in the lymphadenectomy group compared to no lymphadenectomy group (86.5% vs 74.4% , P = 0.048). In particular, in the case of high-grade serous ovarian carcinoma, there was a significant difference in lymphadenectomy group and no lymphadenectomy group (84.3% and 63.2%, P = 0.008). There was no difference in PFS in mucinous (P = 0.67), endometrioid (P = 0.41), and clear cell (P = 0.89) ovarian carcinomas between the two groups. Conclusions: This study showed that in patients with clinical eEOC, histological subtype is associated with a survival benefit for lymphadenectomy. In serous ovarian carcinoma, lymphadenectomy showed improvement in PFS, but other histological subtypes did not differ significantly. Considering the higher risk of perioperative adverse events in lymphadenectomy, lymphadenectomy in patients with clinically eEOC can be considered and selected according to histological subtype.