Renal impairment is a common complication in patients with ovarian cancer. Renal impairment in ovarian cancer patients can be caused by various factors. Many of the chemotherapeutic agents administered to treat ovarian cancer are nephrotoxic and can promote kidney dysfunction, leading to renal impairment. Ovarian tumors can obstruct the urinary tract, leading to a reduction in renal function and dilation of the upper urinary tract. Acute kidney injury (AKI) can occur in ovarian cancer patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Women treated for epithelial ovarian cancer suffer an accelerated rate of renal function decline, independent of major risk factors for kidney disease. Conversely, renal impairment can affect the dosage of chemotherapy drugs used in ovarian cancer treatment. Dose reduction, dose adjustment based on pharmacokinetic data, alternative treatment regimens, and individualized dosing may be necessary to ensure optimal therapeutic outcomes while minimizing the risk of toxicity and treatment-related complications.