Introduction <p>Common cancer treatments, including chemotherapy and radiotherapy, often impaired reproductive function, posing fertility challenges for young patients with cancer. Therefore, fertility preservation seems necessary in young patients with cancer. So far, limited studies have been conducted on fertility preservation among patients with cancer in Iran. This scoping review aimed to map barriers to fertility preservation among patients with cancer in Iran.</p> Methods <p>A systematic search was conducted on published article between 1990 and 2024 in SID, Google scholar, PubMed, Cochran, Scopus, and Web of Sciences electronic databases. Key terms included fertility preservation, cancer, counseling, interventions, knowledge, attitude and practice and Iranian society.</p> Results <p>From 400 retrieved articles, five relevant studies were included after applying inclusion and exclusion criteria. Key barriers included limited knowledge, attitudes, and practices among parents, physicians, and oncologists, as well as inadequate facilities and counseling for patients with cancer. It was also found that limited effort has been made to help patients with cancer in terms of making decisions about fertility preservation in Iran.</p> Conclusions <p>The results of this systematic review indicated that insufficient measures have been made to preserve fertility in patients with cancer in Iran. Considering the population growth policies, more interventions are necessary to increase knowledge, attitude, and practice of physicians, patients, and their families in terms of fertility preservation. Furthermore, clinical guideline should be designed for the Iranian society to implement fertility preservation counseling in young patients with cancer.</p>