Aim <p>To analyze the status and potential profiles of reproductive concerns in testicular cancer patients in reproductive age and explore the related factors of reproductive concerns levels in different categories of patients.</p> Methods <p>A cross-sectional study was used in this study. A total of 214 patients with testicular cancer of reproductive age from the department of urology, Sun Yat-sen University Cancer Center in Guangdong Province were selected by convenience sampling from January 2024 to January 2025. Data on demographic characteristics, the reproductive concerns after cancer scale-male (RCAC-M), and the fear of progression questionnaire-short form (FoP-Q-SF) were collected. Potential profile analysis of reproductive concerns levels in testicular cancer patients of reproductive age was performed, and binary logistic regression was used to analyze the related factors of reproductive concerns levels in different categories.</p> Results <p>The reproductive concerns score of testicular cancer patients of reproductive age was (58.16 ± 10.99), and their reproductive concerns was divided into two potential profiles: a low level of reproductive concerns group (46.3%) and a high level of reproductive concerns group (53.7%). Those with fertility intention (OR = 4.208, 95% CI: 2.204–8.034) and more severe fear of disease progression (OR = 1.111, 95% CI: 1.069–1.156) were more likely to develop into the high-level reproductive concerns group (all <i>P</i> &lt; 0.05).</p> Conclusion <p>Reproductive concerns in male cancer patients of reproductive age was at a moderate level and showed a substantial heterogeneity. Healthcare professionals should recognize the different reproductive concerns conditions of patients and implement targeted interventions to reduce the reproductive concerns of patients with testicular cancer.</p> Clinical trial number <p>Not applicable.</p>