Surgery is considered a cornerstone in the treatment of advanced ovarian cancer. The absence of macroscopic residual tumor at the end of surgery is associated with a better outcome in primary debulking surgery and secondary cytoreduction for patients with a first relapse. Despite the absence of randomized clinical trials in the front-line setting, nobody questions the value of surgery in the initial management of primary advanced ovarian cancer due to extensive data showing a clear benefit in overall survival of complete cytoreduction after primary debulking surgery and interval debulking surgery. In the first relapse, three randomized clinical trials have produced apparently contradictory results. It is important to mention (for the best understanding of the question that we are dealing with), that only the studies including clearly defined selection criteria for cytoreduction, AGO-OVAR DESKTOP-III and SOC1, have produced a positive result in terms of progression-free survival. In addition, the AGO-OVAR study has also shown a benefit in overall survival.