Advancing age is considered a risk factor for survival in ovarian cancer. Several groups reported at least a twofold increased risk of death in women older than 65 years of age. In this review, we will focus on several aspects of the management of ovarian cancer in the elderly, including the prognostic implications of advanced age, surgical considerations in the frail, chemotherapy options such as intraperitoneal (IP) treatment, and geriatric assessment in predicting toxicity.