The incidence of ovarian carcinoma increases with advancing age, with a peak incidence during the seventh decade of life and continues to elevate until 80 years of age. Despite the high prevalence of ovarian cancer in the elderly, the management of these patients is often less aggressive than that of their younger counterparts with the result being that many elderly cancer patients undergo inadequate treatment. Although some data suggest that age is a negative prognostic factor, there is no evidence that age alone should preclude one from standard therapy. In fact, the majority of elderly patients will be able to tolerate the standard of care for ovarian cancer including initial surgical cytoreduction followed by platinum and taxane chemotherapy. Because functional status does not show a reliable correlation with either tumor stage or comorbidity, each patient’s comorbidities should be assessed independently. For those elderly patients with signiﬁcant medical comorbidity, the extent of surgery and the aggressiveness of chemotherapy should be tailored to the individual’s extent of disease, symptoms, overall health, and life goals. In addition, enhanced cooperation between geriatricians and oncologists may help in the pretreatment assessment of elderly patients and improve treatment guidelines in this population.