ObjectiveTo provide a review of the basic mechanisms of drug resistance in ovarian cancer and novel strategies to modulate drug resistance for the general obstetrician-gynecologist.Data SourcesRelevant articles published through December 1996 were identified using the MEDLINE data base. Additional sources were found by cross-referencing.Methods of Study SelectionPublications identified by the search were reviewed and evaluated critically for their relevance to drug resistance in ovarian cancer.Tabulation, Integration, and ResultsEach reference was reviewed for its contribution to the knowledge regarding mechanisms of chemotherapy resistance in ovarian cancer or strategies to modulate resistance.ConclusionOvarian 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.