The dismal outcome of ovarian, fallopian tube, and primary peritoneal carcinomas calls for an increase in surgical aggressiveness. After a long era during which incomplete cytoreduction was considered acceptable, it has been established that the outcome is directly related to the amount of diseased tissue left in place. Probably as a result of technical imitations of surgeons and anesthesiologists, the majority of teams have fixed a cut-off value of 2 cm to define what was called "optimal" cytoreduction. Although it is now established that reaching the 2 cm cut-off value is the minimal required target, the target has moved towards complete removal of visible implants. However, the methods of assessment of residual disease and the very concept of complete cytoreduction suffer from limitations.