Abstract : Choriocarcinoma is a malignant gestational tropoblastic disease derived from an imbalance between apoptotic activity and cytotrophoblast cell proliferation. The ability of apoptosis and cell proliferation is either associated with telomerase activity. This study aimed to evaluate therapeutic effect from combination Methotrexate and All Trans Retinoid Acid. This research method was experimental with post test-control group design approach. This study used cell culture of choriocarcinoma cell line BeWo (ATCC® CCL-98TM) given exposure to MTX 50 mg, ATRA 400 ɥg/ml, and a combination of both. The measurement of telomerase activity was performed using TeloTAGGG Telomerase PCR ELISAPLUS Kit, while the apoptotic index was performed with Cellular DNA Fragmentation Kit. The data were analyzed by one-way ANOVA test and Least Significance Different 5 percent test (LSD) with correlation level determined by Pearson test. The results showed a significant decrease in telomerase activity between the groups given exposure and control (p = 0.000 <α). Conversely, there was a significant increase in apoptotic index between the group given exposure and control (p = 0.000 <α). The relation between decreased telomerase activity and increased apoptotic index was significant (p = 0,000 <α) with a correlation coefficient of -0.667 indicating that the relationships were still strong. The administration of MTX and ATRA is related to decreased telomerase activity and increased apoptotic index of choriocarcinoma disease. Administering combination of MTX+ ATRA seems to have the potential to provide maximum therapeutic effect on choriocarcinoma.