BACKGROUND/AIM To evaluate ovarian cancer surgery in tertiary centers (TC) and regional hospitals (RH). PATIENTS AND METHODS Data from the GynOp registry on patients undergoing surgery for ovarian cancer or borderline tumor from 2013 to 2015 were analyzed. RESULTS Four TC and 21 RH reported 1,108 cases of surgery with curative intent, 770 cases (69.5%) in TC and 338 cases (30.5%) in RH. Out of 458 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC-IV disease 396 (86.5%) had surgery in TC. We found differences in selection for primary debulking surgery (PDS) (45% to 93%, p<0.001) and PDS achieving no residual tumor (36% to 70%, p<0.001) between the four TC. Major complications, re-admissions and re-operation rates did not differ between TC and RH. CONCLUSION Tertiary centers perform more extensive surgery compared to regional hospitals without increased frequency of major complications. Tertiary centers display significant differences among patient selection for PDS, as well as achieving no residual tumor.