The purpose of this study is to understand the features of gynecologic oncology patients who receive ethics consults in order to identify areas for physician education and improve patient care. A review of ethics consults for gynecologic oncology patients from 1993 to 2008 was performed. Information on all gynecologic oncology patients treated during the study interval was also collected to define a base population for comparison. Forty-one consults were performed. Compared to the base population, a greater proportion of consult patients had pregnancy-related malignancies (7.9% vs. 0.8%, p < 0.0001) and were African American (33.3% vs. 10.9%, p < 0.0001). The most common clinical case types involved identifying levels of appropriate treatment. Support of the health care team and complex family dynamics were key underlying issues. Ethics consultation provides a substantial resource in identifying relevant issues experienced by gynecologic oncology patients upon which physician educational initiatives may be based.