About one third of the women diagnosed with ovarian cancer present with localized disease. Accurate surgical staging is required to properly evaluate these patients, define appropriate treatment, and establish prognosis. A series of recent studies have clarified which patients can be managed with comprehensive surgical staging and disease removal alone, and which may benefit from adjuvant therapy. A series of national and international prospective randomized trials are evaluating a variety of adjuvant treatments that may enhance long-term survival in those patients with early ovarian cancer who do require additional therapy.