Ovarian cancer is a lethal disease affecting around 314,000 women annually, with a predicted increase in cases and deaths globally. Despite advancements in treatment, ovarian cancer remains challenging to manage, with high-grade serous ovarian cancer (HGSC) being the most common histological type. Most patients present at advanced stages, leading to poor survival rates. Screening programs have been investigated, but no national program has been established due to the lack of mortality benefit in randomized controlled trials (RCTs). Research has focused on ultrasound, serum CA125, and biomarker-based strategies, but these have not led to significant improvements in outcomes. For women at high risk, surgical prevention remains the gold standard, with risk-reducing salpingo-oophorectomy (RRSO) being recommended for BRCA carriers and individuals with a lifetime risk of ovarian cancer of 10% or more. Other preventive approaches include early salpingectomy and delayed oophorectomy (RRESDO) and opportunistic bilateral salpingectomy (OBS) for women at average population risk. Genetic testing is also being expanded to identify individuals at increased risk, including those with moderate penetrance cancer susceptibility genes (CSGs). Novel biomarkers and screening strategies, such as DNA methylation, cell-free DNA, and multicancer early detection (MCED) tests, are being explored to improve early detection and reduce the burden of ovarian cancer. However, challenges remain, including the low prevalence of cancer in the general population and the need for more robust biomarkers to detect early-stage disease. The review highlights the current landscape of ovarian cancer screening and prevention, emphasizing the need for further research and the potential role of unselected genetic testing to identify individuals at increased risk who can benefit from preventive strategies.Ovarian cancer is a lethal disease affecting around 314,000 women annually, with a predicted increase in cases and deaths globally. Despite advancements in treatment, ovarian cancer remains challenging to manage, with high-grade serous ovarian cancer (HGSC) being the most common histological type. Most patients present at advanced stages, leading to poor survival rates. Screening programs have been investigated, but no national program has been established due to the lack of mortality benefit in randomized controlled trials (RCTs). Research has focused on ultrasound, serum CA125, and biomarker-based strategies, but these have not led to significant improvements in outcomes. For women at high risk, surgical prevention remains the gold standard, with risk-reducing salpingo-oophorectomy (RRSO) being recommended for BRCA carriers and individuals with a lifetime risk of ovarian cancer of 10% or more. Other preventive approaches include early salpingectomy and delayed oophorectomy (RRESDO) and opportunistic bilateral salpingectomy (OBS) for women at average population risk. Genetic testing is also being expanded to identify individuals at increased risk, including those with moderate penetrance cancer susceptibility genes (CSGs). Novel biomarkers and screening strategies, such as DNA methylation, cell-free DNA, and multicancer early detection (MCED) tests, are being explored to improve early detection and reduce the burden of ovarian cancer. However, challenges remain, including the low prevalence of cancer in the general population and the need for more robust biomarkers to detect early-stage disease. The review highlights the current landscape of ovarian cancer screening and prevention, emphasizing the need for further research and the potential role of unselected genetic testing to identify individuals at increased risk who can benefit from preventive strategies.