Ovarian cancer is the fifth leading cause of cancer-related death in women in the United States. Because success in early screening is limited, and most patients with advanced disease develop resistance to multiple treatment modalities, the overall prognosis of ovarian cancer is poor. Despite the revolutionary role of surgery and chemotherapy in curing ovarian cancer, recurrence remains a major challenge in treatment. Thus, improving our understanding of the pathogenesis of ovarian cancer is essential for developing more effective treatments. In this review, we analyze the underlying molecular mechanisms leading to chemotherapy resistance. We discuss the clinical benefits and potential challenges of using nanocarrier-delivered small interfering RNA to treat chemotherapy-resistant ovarian cancer. We aim to elicit collaborative studies on nanocarrier-delivered small interfering RNA to improve the long-term survival rate and quality of life of patients with ovarian cancer. This article is categorized under: RNA Methods > RNA Nanotechnology Regulatory RNAs/RNAi/Riboswitches > RNAi: Mechanisms of Action K E Y W O R D S chemotherapy resistance, nanocarrier, ovarian cancer, small interfering RNA, targeted therapy 1 | INTRODUCTION Ovarian cancer is the second most common gynecological cancer and the fifth leading cause of cancer-related death among women in the United States. Globally, approximately 313,959 newly diagnosed cases and 207,252 deaths were reported in 2020 (GLOBOCAN, 2020). Ovarian cancer usually occurs shortly before or after menopause, and the average age of diagnosis is around 63 years (Shen et al., 2017). Histologically, ovarian cancer is divided into three types: epithelial tumors (>85% of cases), stromal tumors, and germ cell tumors. Each subtype has distinct etiology and clinical characteristics. Most cases of ovarian cancer are diagnosed in an advanced stage (Stage III/IV), as patients often have no obvious symptoms or only mild and atypical symptoms during the early stage of disease (Goff et al., 2000;Natanzon et al., 2018;Smyth et al., 1997). Although diagnostic technology has advanced in the past decade, it is still difficult to detect early-stage ovarian cancer. Currently, surgery and chemotherapy are commonly used to treat ovarian cancer (Schorge et al., 2010). Particularly, platinum-and taxane-based chemotherapy after surgery is the standard regimen for patients with advanced disease (