Despite an aggressive treatment strategy for high grade serous ovarian cancer (HGSOC) that incorporates cytoreduction, platinum compounds, anti-angiogenic agents, and poly (ADPribose) polymerase (PARP) inhibitors, most patients, especially those who are with stage III-IV HGSOC, will relapse. The management of recurrent HGSOC is a challenging issue faced by gyneco-oncologists and medical oncologists in clinical practice. This chapter provides an overview of the current optimal management of recurrent HGSOC. First, recurrence is classified based on the time of onset. This is followed by a discussion on the place of surgery within the treatment strategy. Finally, the role of systemic treatments (chemotherapy, targeted Note to the reader: This chapter is part of the book Ovarian Cancer (ISBN: 978-0-6453320-8-7), scheduled for publication in September 2022. The book is being published by Exon Publications,