Aim of this study was to provide a review of the basic mechanisms of drug resistance in ovarian cancer and novel strategies to modulate drug resistance. Relevant articles published through August 1999 were identified using the Medline data base. Publications identified by the search were reviewed and evaluated critically for their relevance to drug resistance in ovarian cancer. Ovarian cancer patients have high response rates to initial chemotherapy after cytoreductive surgery. However, most will develop resistance to chemotherapy during the course of their treatment. There are multiple mechanisms resulting in drug resistance. Strategies to modulate drug resistance include dose intensity, various pharmacologic agents, and gene therapy.