CA125, the most widely used ovarian cancer (OC) biomarker, was first identified approximately thirty-five years ago in an antibody screen against OC antigen. Two decades later, it was cloned and characterized to be a transmembrane mucin, MUC16. Since then several studies have investigated its expression, functional and mechanistic involvement in multiple cancer types. Antibody based therapeutic approaches primarily using antibodies against the tandem repeat domains of MUC16 (for example Oregovomab and Abagovomab) have been the modus operandi for MUC16 targeted therapy, but met with very limited success. In addition, efforts are also made to disrupt the functional co-operation of MUC16 and its interacting partners, for example use of a novel immunoadhesin HN125 to interfere MUC16 binding to mesothelin. Since the identification of CA125 to be MUC16, it is hypothesized to undergo proteolytic cleavage, a process that is considered to be critical in determining the kinetics of MUC16 shedding as well as generation of a cell associated carboxyl-terminal fragment with potential oncogenic functions. In addition to our experimental demonstration of MUC16 cleavage, recent studies have demonstrated the functional importance of carboxyl terminal fragments of MUC16 in multiple tumor types. Here, we provide how our understanding of the basic biological processes involving MUC16 influences our approach towards MUC16 targeted therapy.