Surgery has various applications in the management of cancer. This chapter discusses the roles performed by surgery such as: diagnosis, staging, treatment, reconstruction, and palliation. It reviews the intraoperative complications of laparotomy. A number of studies have proposed chemotherapy before definitive surgery in patients with advanced ovarian carcinoma. A significant number of women with recurrent disease will develop bowel obstruction, and surgery is often the palliation method of choice. Stage IB disease can be treated by surgery or radiotherapy, and the surgical options are radical vaginal hysterectomy and laparoscopic or extraperitoneal lymph node dissection, and radical trachelectomy with laparoscopic or extraperitoneal lymph node dissection. The standard surgical management for endometrial cancer in the UK has been total abdominal hysterectomy and bilateral salpingo-oophorectomy. Biopsy of a vulval lesion is essential for diagnosis before definitive surgery. Conservative surgery should be considered for young patients with early cervical cancer.