Borderline Ovarian Tumours (BOTs) comprise 15-20 % of all epithelial ovarian tumours. BOTs are characterised by increased mitotic activity but lack infiltrative destructive growth and stromal invasion. Several dilemmas and controversies have been discussed in the literature regarding BOT management including surgical approach (radical versus fertility-sparing surgery), surgical route (open versus laparoscopic surgery) and impact on disease recurrence, follow-up protocols/modalities (imaging, serum biomarkers), role of completion surgery, lymph node dissection during staging, adjuvant chemotherapy, as well as use of Hormone-Replacement Therapy (HRT) post-surgery. We performed a structured narrative review on Medline and Cochrane Library Databases to identify studies pertaining to the management of BOTs. Identifying areas of agreement and outstanding uncertainty are integral to optimise robust treatment regimens for BOT management and improve the Quality of Life (QoL) and clinical outcomes for patients. We discuss a framework of recommendations to counsel, manage and follow-up women diagnosed with BOT.