Abstract: Ovarian cancer is a common gynecological malignant tumor with the highest mortality. The treatment of ovarian cancer has not been effectively improved for a long time, while the chemotherapy drug resistance has made it even more difficult. Previous studies showed that the chemotherapy drug resistance was relevant with the abnormity of drug targets, DNA damage repair system and apoptosis regulation. Recent studies suggest that drug resistance could be divided into pre-target, on-target, post-target and off-target mechanism. In addition, there are many new findings which have promoted the study of resistance mechanism, such as the changes in the microenvironment of ovarian cancer. In the meantime, the prediction and response of drug resistance, especially the reversal of drug resistance in traditional Chinese medicine, has been further studied and improved the effective treatment of ovarian cancer.