Nature Reviews Clinical Oncology, Published online: 17 June 2026; doi:10.1038/s41571-026-01164-9Three antibody–drug conjugates (ADCs) are currently approved for previously treated gynaecological cancers: mirvetuximab soravtansine for folate receptor-α-positive ovarian cancer, trastuzumab deruxtecan for solid tumours expressing HER2 and tisotumab vedotin for cervical cancer (independent of tissue factor expression). The authors of this Review discuss current priorities in the clinical development of ADCs for gynaecological cancers, such as identifying novel targets, understanding mechanisms of resistance and sequencing strategies, and managing toxicities, highlighting key advances and future opportunities.