Purpose of Investigation: This study was conduced to assess the results of paclitaxel plus cisplatin given over six months as first­line therapy in women with stage III and IV epithelial ovarian cancer with residual disease <1 cm and compare it to our previous standard of cisplatin, adriamycin, and cyclophosphamide given over ten months in two sequential trials totaling 100 patients. Methods: We compared induction weekly cisplatin (1 mg/kg × 4) followed by monthly cisplatin (50 mg/m²), doxorubicin (50 mg/m²) and cyclophosphamide (750 mg/m²) × 10 (n = 56) versus induction cisplatin (1mg/kg × 4) followed by cisplatin (75 mg/m²) and paclitaxel (135 mg/m²) monthly over six months (n = 44). Results: The two groups were similar in age, histologic subtypes, grade, performance status, and substage. The mean dose of cisplatin in the PAC patients was 617.1 (± 92.7) mg/m² as compared to 567.1 (± 89.2) mg/m² in the TP patients (p < 0.0001). Surgical response was assessed in 83.9% of the PAC and 86.4% of the TP patients. The incidence of nausea and vomiting, myelotoxicity, and renal toxicity were similar in the two groups. Peripheral neuropathy occurred more frequently following TP (57% vs 16%; p = 0.001). Cardiac toxicity (grade 1) occurred in 39% of the PAC patients and in 4.5% of the TP patients (p < 0.0OI). The overall response rate (75% vs 88.7%), surgical response rate (67.9% vs 79.5%), complete surgical responses (37.5% vs 40.9%), estimated two-year survival (80.2% vs 79.6%), progression-free median survival (36 months vs 30.4 months) and two-year progression/recur­rence rates (32.3% vs 46.9%), respectively, of PAC and TP patients were not statistically significant (p = NS). Conclusions: Given the discussed limitations of the study, compared with PAC, TP did not improve overall and surgical response rates, two-year survival, two year disease-free survival, or median time of recurrence in patients with optimal (<1 cm) stage III and IV ovarian cancer and resulted in higher peripheral neuropathy rates.