Scientific and biomedical achievements have enabled infertile couples to achieve parenthood through assisted fertilization methods as an alternative form of reproduction. Surrogacy is the best example of the far-reaching nature of assisted reproduction and represents the most complex medical-legal-ethical form of human conception. It polarizes public opinion and encourages moral, ethical, and legal debates. It calls into question the traditional concept of the family, especially motherhood, because it contradicts the social and legal presumption that the child's mother is the woman who gave birth (mater semper certa est). Recognition of the citizenship of children born by international surrogacy has become a burning legal issue in the focus of international debate. The European Court of Human Rights (ECtHR) also addresses the above problem, which places the child's best interest on the pedestal of social priorities and violates the child's rights. Ethical dilemmas raised by surrogacy concern preserving human dignity, exploiting surrogate mothers, and engaging in child trafficking. For this reason, many countries prohibit surrogacy. However, despite the indisputable complex legal and ethical dilemmas, surrogate motherhood is gaining increasing legitimacy in many countries worldwide. This is evident from the implicit acceptance and court approval of surrogacy in numerous American states. Additionally, some countries legally regulate surrogacy, prescribing (strict) conditions that must be met by both contracting parties to fulfill “contractual obligations successfully.” Finally, the latest trends are toward adopting international normative and ethical guidelines for protecting the rights of children born through international surrogacy.