A surgical strategy gaining momentum could dramatically reshape ovarian cancer prevention for women no longer planning pregnancies. The approach involves removing fallopian tubes during other scheduled pelvic procedures, potentially eliminating the primary source of what we commonly call ovarian cancer. The European Society of Gynaecological Oncology has now issued evidence-based consensus statements supporting this opportunistic approach for eligible women. The rationale centers on a fundamental reframing of ovarian cancer biology. Most high-grade serous carcinomas—the deadliest form of ovarian cancer—actually originate in the fallopian tubes, not the ovaries themselves. These cancers then spread to ovarian surfaces, creating the misleading impression of ovarian origin. By removing tubes during procedures like hysterectomy or sterilization surgery, surgeons can eliminate this cancer pathway without additional operative risk or recovery time. The consensus represents a shift from reactive screening approaches, which have proven largely ineffective for ovarian cancer, toward primary prevention. Current screening methods detect ovarian cancers too late for optimal outcomes, making prevention strategies particularly valuable. However, this approach requires careful patient selection and thorough counseling about permanent fertility loss. The procedure appears most beneficial for women over 35 who have completed childbearing, particularly those with genetic predispositions to ovarian cancer. While promising, the strategy still requires long-term population studies to quantify exact risk reduction percentages. The consensus acknowledges limitations in current evidence, noting that definitive proof of prevention efficacy may take decades to establish through randomized trials. Nevertheless, the convergence of biological understanding and surgical feasibility makes opportunistic salpingectomy an increasingly compelling option for appropriately selected women seeking proactive cancer prevention.