The treatment of ovarian cancer has evolved over the past two decades from one of palliation to one where patients can achieve prolonged remission and cure. Although prognosis remains poor, it has improved with the intervention of a multidisciplinary team and greater site specialization in the organization of cancer services. The introduction of new chemotherapy agents both as first line treatment and on relapse has had a benefit in terms of overall survival and progression-free survival. In this review we describe first-line therapy, including the use of intraperitoneal chemotherapy, the importance of dose and dose intensity in platinum agents and the treatment of refractory and relapsed disease. Finally the review focuses on important prognostic factors and how these can be used to predict outcome.