The article reviews the impact of chemotherapy on the ovarian microenvironment and its consequences for ovarian function. Chemotherapy can cause an imbalance in the ovarian microenvironment, leading to disturbances in hormone levels, reduced fertility, and an increased risk of early menopause. The ovarian microenvironment, which includes the extracellular matrix (ECM), stromal cells, vascular system, immune components, and stem cells, plays a crucial role in follicle development and maintenance. Changes in this environment during chemotherapy include ECM deposition, stromal fibrosis, angiogenesis disorders, immune microenvironment disturbance, oxidative stress imbalances, and ovarian stem cell exhaustion. These changes can lead to a decrease in the number and quality of ovarian follicles. The review highlights the importance of developing new therapeutic strategies to protect ovarian function by targeting the ovarian microenvironment, such as stem cell therapy, free radical scavengers, senolytherapies, immunomodulators, and proangiogenic factors. Understanding the complex interactions within the ovarian microenvironment and its regulatory networks is essential for creating innovative strategies to counteract the effects of chemotherapy on ovarian function.The article reviews the impact of chemotherapy on the ovarian microenvironment and its consequences for ovarian function. Chemotherapy can cause an imbalance in the ovarian microenvironment, leading to disturbances in hormone levels, reduced fertility, and an increased risk of early menopause. The ovarian microenvironment, which includes the extracellular matrix (ECM), stromal cells, vascular system, immune components, and stem cells, plays a crucial role in follicle development and maintenance. Changes in this environment during chemotherapy include ECM deposition, stromal fibrosis, angiogenesis disorders, immune microenvironment disturbance, oxidative stress imbalances, and ovarian stem cell exhaustion. These changes can lead to a decrease in the number and quality of ovarian follicles. The review highlights the importance of developing new therapeutic strategies to protect ovarian function by targeting the ovarian microenvironment, such as stem cell therapy, free radical scavengers, senolytherapies, immunomodulators, and proangiogenic factors. Understanding the complex interactions within the ovarian microenvironment and its regulatory networks is essential for creating innovative strategies to counteract the effects of chemotherapy on ovarian function.