Surgery is a critical component of the multimodality approach to ovarian cancer. Surgery confirms the diagnosis and establishes the stage of disease, especially important when the tumor appears to be limited to the ovaries. In advanced disease, surgical cytoreduction improves response to chemotherapy and survival. Second-look laparotomy provides a means for assessing response to therapy, predicting prognosis, and determining the need for further therapy. Surgery can also provide palliation of intestinal obstruction.