Over the past 10 years, significant advances have been made in the treatment of epithelial ovarian cancer in the United States. Women are living longer with ovarian cancer, and the survival for all cases in the U.S. has increased. Some, but not all, of this success is secondary to new surgical approaches. New techniques, new philosophies and new technology have changed the surgical approach to ovarian cancer in a variety of clinical situations, and these changes have affected the care of women with ovarian cancer. Access to specialist surgeons continues to be very important in the care of women with ovarian cancer to ensure adequate staging, optimal cytoreduction and application of secondary cytoreduction when appropriate. Further work needs to be undertaken in screening, prevention, surgery and adjuvant therapy.