Treatment for patients with advanced ovarian cancer includes a combination of platinum-based chemotherapy and maximally cytoreductive surgery. The 2 options for initial treatment include upfront surgery followed by adjuvant chemotherapy or neoadjuvant chemotherapy followed by interval surgery. Deciding between which approach is a on the basis of several factors: (1) resectability of disease; (2) patient factors such as age, albumin, and body mass index; (3) patient wishes; and (4) overall functional status. Research is needed to further refine these approaches and create a patient-focused treatment plan which includes novel factors such as molecular subtype of disease and frailty and sarcopenia.