Forty-two patients with ovarian cancer underwent "second-look" laparotomy to determine disease status. Seventeen patients were free of disease; 15 demonstrated tumor regression, but microscopic (3) or macroscopic (12) cancer persisted; and 10 had progressive disease. A significantly increased correlation between positive biopsy sites at second look and sites of known initial residual cancer was noted (76.7% versus 42.3% total positive), particularly in patients with minute disease, at second look. This correlation increased (85.3% versus 64.8%) when both the initial tumor reduction and documentation of residual disease and the second-look procedure were performed by the same surgeon. No such difference was noted in patients with progressive disease. In no instance was disease found at new sites when sites of previous residual cancer were disease free. These results underscore the need for accurate documentation of residual tumor after initial tumor reduction in order to direct the biopsy pattern more accurately, particularly in patients with minute or microscopic disease at second look.