Twenty-four patients with epithelial ovarian cancer who had negative second-look laparotomy (SLL) were assessed in regard to recurrent disease. Four patients showed recurrence 11-36 months after negative SLL. All four patients had advanced stage and grade III tumors, with two having residual tumors greater than 1 cm in diameter after initial laparotomy. We believe that patients with advanced stage and high-grade tumors should receive some kind of treatment after negative SLL.