Para-aortic lymphadenectomy (PAL) is the cornerstone in the management of many gynecological malignancies. Para-aortic lymphadenectomy is often recommended in the surgical staging of advanced cervical cancers before radiation to determine the extent of the fields. It is also used in the therapeutic management of type 2 and high-risk type 1 en- dometrial cancers. Para-aortic lymphadenectomy specifically including dissection of the infrarenal lymph nodes remains a standard of care for the accurate staging and debulking of ovarian cancer.