<p>Ovarian cancer (OC) is the most lethal gynecologic malignancies worldwide, is characterized by poor prognosis and limited treatment options. While immunotherapy has shown promise in treating gynecologic cancers, particularly OC, its efficacy against OC remains suboptimal due to the distinct immune evasion mechanisms within the OC tumor microenvironment (TME). Post-translational modifications (PTMs), which involve enzyme-catalyzed attachment of functional groups to proteins, inducing structural and functional alterations, are emerging as critical regulators in tumor immunotherapy. In this review, we comprehensively summarize various PTMs that modulate the immune response in OC, primarily including ubiquitination, phosphorylation, glycosylation, and acetylation. We specifically focus on how these PTMs modulate key immune checkpoint molecules and immune evasion. Elucidating the roles of PTMs in the OC immune response could provide novel strategies for enhancing the efficacy of immunotherapy.</p>