Objective To achieve consensus on treatment strategies for patients with inoperable or peroperatively unresectable epithelial ovarian cancer. Design A modified Delphi method was employed. Setting The study was conducted in academic and regional hospitals across the Netherlands specializing in the treatment of ovarian cancer. Population or Sample Participants included gynaecologists, gynaecologic-oncologists and medical oncologists. Methods Three survey rounds were conducted with a structured questionnaire featuring clinical case-scenarios, with anonymized feedback and aggregated responses after each round to refine consensus (defined as ≥80% agreement). Main Outcome Measures Consensus on treatment strategies for inoperable or peroperatively unresectable epithelial ovarian cancer. Results Seventeen clinicians representing all academic centres in the Netherlands completed all three rounds of survey. Consensus was achieved on 9 statements. Agreement was reached on the continuation of systemic therapy for patients in good clinical condition following neoadjuvant chemotherapy and on transitioning to best supportive care for those in suboptimal condition after futile laparotomy (peroperatively unresectable disease). Variability was observed in the choice of systemic therapy regimens. During the study, clinicians identified a strong preference for shared decision-making and highlighted the need for decision-aids to facilitate patient-clinician discussions. Conclusions This study provides consensus for the management of inoperable and peroperatively unresectable epithelial ovarian cancer. However, lack of agreement on systemic therapy regimens underscores the urgent need for further research.