Background: Small cell carcinoma of the lung (SCCL) is rarely associated with ovarian metastases. Only occasional cases have been reported so far. Since SCCL is increasing in women because of smoking, the frequency of ovarian metastases from SCCL may increase in the near future. Case: A 54-year-old woman with SCCL presented with a left ovarian mass, 4.8 cm in diameter. The microscopic appearance of the ovarian tumor was identical to that of the previous bronchoscopic biopsy. Molecular analysis of p53 demonstrated an identical point mutation (S215) in both tumor sites. Moreover, a p53 DNA polymorphism (P52R) was identified in normal tissue, but present in homozygosity in both tumor sites. Conclusion: In this article, we report a new example of SCCL metastatic to the ovary, and we discuss the main features for differential diagnosis with primary ovarian small cell carcinoma, pulmonary type, with emphasis on the value of p53 analysis.