Introduction: Poly ADP-ribose polymerase inhibitors (PARPi) can extend progression-free survival in ovarian cancer (OC). In 2020, niraparib, a PARPi, was approved in Canada as maintenance therapy for advanced OC following front-line chemotherapy. Despite increasing use of PARPi, reasons why patients initiate treatment and their perspectives on PARPi, have not yet been extensively investigated. We aimed to explore patient perspectives of niraparib treatment. Methods: Canadians who initiated niraparib monotherapy were recruited. Recruitment is ongoing for those who decided against PARPi. Virtual semi-structured qualitative interviews were conducted. Interviews were transcribed and analyzed using reflexive thematic analysis. Results: Ten women from four provinces participated (mean [range] age, 66 [51-80] years); all diagnosed with epithelial OC between 2020-2024. Mean (range) time on niraparib was 22 (<1-37) months. Although participants trusted their oncology team, they wanted to be central in the decision to initiate niraparib. However, the level of involvement recounted varied. Participants valued the potential for niraparib to increase time to recurrence and survival. Participants reported having a sense of ‘control’ and ‘peace of mind’ on niraparib; despite there being no clear signs of it ‘working’ (due to the nature of maintenance therapy). Participants nearing niraparib completion were apprehensive, and desired more education on treatment duration and options after niraparib. Conclusions: Findings highlight a range of extents of patient involvement in niraparib initiation; nevertheless, all participants valued trying niraparib. Results suggest there is a need to enhance patient education, particularly on options post-niraparib. Contextualizing these findings with evidence from women who decide against PARPi will provide patients with insight for when faced with similar decisions and facilitate patient-centered care.