The incidence of unsuspected metastasis to the diaphgram, retroperitoneal lymph nodes, and omentum as well as malignant cytologic peritoneal washings in women with presumed localized ovarian cancer is presented. Of the women with presumed Stage I ovarian cancer, from our clinical experience and those reported in the literature, 11.3% were found to have diaphragmatic metastases, 13.3% had aortic lymph node metastases, 8.1% had pelvic lymph node metastases, 3.2% had omental metastases, and 32.9% had malignant peritoneal washings. In Stage II ovarian cancer, 23% were found to have diaphgragmatic metastases, 10.0% had aortic lymph node metastases, 0% had omental metastases, and 12.5% had malignant peritoneal washings.