Hereditary breast and ovarian cancer and Lynch syndrome are hereditary conditions that increase risk of developing cancer, including epithelial ovarian cancer (EOC). The risk of developing EOC is dependent on the inherited gene with a pathogenic variant (e.g., BRCA1 or PMS2). Risk-reducing salpingo-oophorectomy (RRSO) is a procedure in which fallopian tubes and ovaries are removed to reduce the risk of EOC. In Manitoba, individuals at risk of gynecologic cancers may be referred to the Hereditary Gynecology Clinic (HGC) to discuss and/or complete RRSO. To better serve individuals at risk for EOC, we wished to understand factors that influence decisions to undergo RRSO across a spectrum of risk levels. This study is composed of two arms. Arm 1 is a retrospective chart review to characterize the overall study population stratified by risk level. Arm 2 is a mixed-methods study involving an online survey and interviews to understand how people interpret their risk of EOC and make decisions regarding RRSO. Arm 1 showed that referral to, as well as completion of RRSO at, the HGC is significantly associated with risk level. Additionally, there is high variability in referral to the HGC for the low-risk population. Age is a significant predictor of completion of RRSO at the HGC, with probability of completion peaking at ~52-years-old, then declining. Arm 2 indicates that although participants found objective risk information beneficial, integration of ‘experiential knowledge,’ and perceived control over each cancer type was important for subjective risk interpretation. Overall, factors such as childbearing, hormonal impacts, perceived risk and control were important to the decision-making process across all risk levels. Both direct and indirect influences of healthcare providers on the decision-making process were evident.