Based on the poor 5-year survival rates for advanced ovarian cancer, novel therapies are needed. Because ovarian cancer largely is confined to the peritoneal cavity for much of its natural history, the intraperitoneal administration of chemotherapy is a biologically rationale and novel approach to the delivery of chemotherapy. Interest in intraperitoneal therapy as first-line therapy has been rekindled by three large randomized clinical trials, which have demonstrated improved median overall survival rates. This article reviews these trials and addresses areas of concern and the need for additional trials.