Germ cell tumors (GCT) originate from the primordial germ cells that migrate from the allantois to the various gonadal sites. During this migration, they can get arrested at various extra-gonadal sites, and so GCT can be gonadal or extra-gonadal in origin. The overall incidence of GCT is about 1 in 100,000 children less than 15 years of age. There are two peaks of occurrence. In the neonates and infancy, it is usually the extra-gonadal and testicular sites, while in the adolescents, it is the ovarian and mediastinal sites. Raised serum αFP is a very sensitive biomarker for EST and serum βhCG for choriocarcinoma. Malignant tumors are very chemo sensitive to Platinum based chemotherapy. All GCT’s need to be removed surgically. Malignant GCT’s (MGCT) that are very large benefit from neoadjuvant chemotherapy prior to excision. The overall outcome is better for gonadal MGCT as compared to extra-gonadal MGCT’s.