The standard treatment for ovarian cancer is cytoreductive surgery followed by platinum-based combination chemotherapy. Although high response rates of this treatment are reported, 40-60% of patients achieving a complete response may relapse. Therefore, second-line chemotherapy is required. Second-line chemotherapy of patients with recurrent ovarian cancer should be based on their sensitivity to first-line chemotherapy and the platina-free interval. Patients who respond to the platina-based chemotherapy still may be sensitive to further platina-based chemotherapy. Patients who do not respond to the platina-based chemotherapy or who have relapses shortly after first-line chemotherapy should be considered clinically resistant to further platina-based chemotherapy. For such patients the chemotherapy regimen should be changed. These regimens include paclitaxel and hexamethylmelamine. The effect of intraperitoneal chemotherapy may depend on the size of the largest residual tumor nodule and the patient's sensitivity to previous chemotherapy.