Ovarian cancer represents the leading cause of death from gynecologic neoplasms. The chance of response to secondary treatment is currently disappointing; few agents have shown notable activity in recurrent/progressive patients. Among these agents, gemcitabine represents one of the most interesting newer antineoplastic agents, showing significant activity, synergism with cisplatin, and a mild toxicity profile in both platinum-sensitive and platinum-resistant (and also taxane-pretreated) recurrent/progressive patients. Moreover, first-line combination chemotherapy including gemcitabine has shown promising response rates in phase I and II studies. The ongoing phase III, five-arm, randomized Gynecologic Oncology Group Protocol 182/International Collaborative Ovarian Neoplasm 5 study should clarify the clinical impact of the addition of a third drug to the standard paclitaxel plus carboplatin treatment regimen.