Purpose of Review <p>There have been remarkable advances in pediatric oncology care that have greatly improved overall five-year survival rates for children, adolescents, and young adults who receive a cancer diagnosis. The potential consequence of these live-saving chemotherapy and radiation treatments is future treatment-related fertility loss and premature ovarian failure. This review is focused on oncofertility risk stratification, counseling, fertility preservation options, and outcomes for female patients at risk for treatment-related fertility loss.</p> Recent Findings <p>Major medical societies recommend that all patients receiving cancer treatment receive oncofertility counseling regarding risk for future infertility and premature gonadal failure along with presentation of fertility preservation options. For female patients, oocyte and ovarian tissue cryopreservation/transplantation can be offered as potential means of future fertility restoration while ovarian tissue transplantation can provide an option for reproductive hormone restoration.</p> Summary <p>Fertility preservation is not only a clinical intervention but also a source of hope and a tangible marker of survivorship for many families. The establishment of an oncofertility program can provide a key component of childhood cancer survivorship care to patients and families.</p>