Abstract: Objecitve To identify the pathological features, clinical symptoms and the prognostic factors for adult granulose cell tumor (AGCT) and juvenile granulose cell tumor (JGCT). Methods The pathological features and clinical characters of 40 patients with granulose cell tumors (GCT) between April 2002 and September 2011 were reviewed, and the relevant prognostic factors were analyzed. Results 34 cases (85%) were AGCT, and the average age of onset was 50.1 years old. 6 cases (15%) were JGCT, with an average 35.3 years old age of onset. The difference of average onset age was significant (P=0.034). The histopathological patterns of AGCT were mainly follicular, insular and trabecular, Call-Exner bodies were found frequently, while the luteinization, hemorrhage and necrosis of tumor cells were not common. In contrast, the histopathological pattern of JGCT was mainly diffuse, Call-Exner bodies were rare, while the luteinization, hemorrhage and necrosis of tumor cells were common. The pathological features of the cases with unfavorable prognosis were:① Mixed mode with tumor cell histopathological pattern (follicular, insular, trabecular and diffuse pattern, the tumor cells were mainly organized in two or more than two kinds of patterns above). ② Call-Exner bodies were rare;③ mitosis number of tumor cells ≥ 3/10 HPF ④ low expression of PTEN and high expression of Ki-67. Conclusion The histological patterns, mitosis number, the expression rate of PTEN and Ki-67 were identified to predict the prognosis for GCT of ovary.