Cancer of the ovary is usually discovered in an advanced stage after development of peritoneal carcinosis. Surgery is a fundamental element for diagnosis and treatment. Therapeutic strategy for cancer of the ovary discovered in an advanced stage includes first-line surgery and systematic postoperative chemotherapy. The essential prognostic factor is the quality of the initial surgical resection and the size of the residual tumoral tissue. Hysterectomy with adnexectomy, omentectomy, lumbo-ovarian and pelvic node dissection and extensive excision of visible carcinosis nodules, with if need digestive resection, are required for optimal tumor reduction. This aggressive surgery should be performed by well trained surgical teams.