• The type of abdominal incision—transverse or vertical—in 291 women with ovarian cancer and completeness of intraoperative evaluation of the extent of disease were investigated. Fourteen percent of woman had transverse incisions, 69% of which were the Pfannenstiel type. Half of the women who had transverse incisions and ovarian cancer were aged 50 years or older. A preoperative diagnosis presumptive of ovarian cancer was made in 93% of women; 71% of the transverse incision group had incomplete intraoperative evaluations of the extent of disease compared with 42% of the vertical incision group. A transverse incision should never be performed in women who are suspected to have ovarian cancer or in women who have ovarian or adnexal tumors and are over 30 years of age. (Arch Surg 1986;121:800-802)