Abstract: Ovarian cancer is a serious threat to women's reproductive health. Epithelial carcinoma is the most common pathological type of ovarian cancer. In addition, epithelial carcinoma demonstrates the highest mortality among all types of gynecological tumors. Despite the recent advances in surgery, radiation, and chemotherapy, recurrence or deterioration still occurs in 75% –80% of patients after treatment. Multidrug resistance is a major cause of post-treatment relapses, metastasis, and even death. This characteristic se -verely restricts the survival of patients with epithelial ovarian cancer. Signaling pathways are important regulatory mechanisms of mul -tidrug resistance. To date, research on the mechanisms of action of these pathways has progressed, and clinical trials on specific inhibi -tors obtained satisfactory results. This study explores the potential relationship between signaling pathways and multidrug resistance in epithelial ovarian cancer, as well as the current progress in clinical research on targeted drugs, to provide a theoretical basis for clini -cal applications.