The paper presents key aspects associated with modern approach to surgical treatment of women with ovarian cancer. It should be emphasized that the best treatment outcomes depend on optimal surgical resection and adjuvant chemotherapy based on taxanes and platinum derivatives. Primary surgical treatment includes determination of clinical stage and total excision of the tumor. If this is impossible, e.g. due to far-advanced disease, the only viable option is maximal cytoreduction. In spite of significant progress in surgical techniques and improved response to first-line chemotherapy, failure of combined treatment over the first 2 years are seen in about 40-50% of the cases. Effectiveness of treatment of recurrent disease is poor and depends on response to first-line treatment, treatment-free survival and patient’s general condition. In exceptional situations, ovarian cancer patients may undergo fertility-preserving sparing procedures. This may be an option with unilateral tumor at FIGO stage IA and IC, patient is young, plans pregnancy and willing to accept close postoperative surveillance. Treatment of ovarian cancer is an area with a tremendous potential for improvement and should remain an ongoing challenge for modern science. In such a complex therapeutic process, surgical treatment still plays a crucial role – it is always indicated in ovarian cancer patients, while its scope and technique depend on individual requirements and condition of women treated.