Small cell carcinoma of the ovary (SCCO) is a rare, malignant and very aggressive tumor. According to the current state of the art, no standard treatment has been established, both in terms of treatment modalities and outcomes. With the exception of some very rare cases reported in literature, the prognosis remains very poor and mortality rate extremely high. We report of three cases of SCCO with rapid progression and spreading of the disease despite multifactorial therapies. Different treatment options have been administered to our patients, but none of them was successful in achieving satisfactory outcomes and/or disease control.