In the 10-year interval from 1972 through 1981, 247 patients were treated for epithelial ovarian carcinoma at New York University Medical Center. Of this group, 31 patients (12.6%) were below age 40, and this group had distinctive features favoring longer survival. Of these patients 12 (38.7%) had borderline tumors, compared to 9 of 216 patients (4.2%) over 40 years of age (P less than 0.001). Stage I disease and well differentiated lesions were also common in the younger group. Early symptomatology and frequent gynecologic examinations during the childbearing years may also contribute to early detection of these tumors. The median survival in this group (7 years) was better than that reported for all ages. After careful evaluation, conservative surgical management can be considered for patients with Stage Ia disease which is either borderline or grade 1 carcinoma.