Gynecological malignancies may affect women in their reproductive age. New developments in surgical technique, new concepts on the radical management of gynaecologic cancers, and a trend towards early diagnosis increase the chances to preserve fertility at the time of surgical management of gynaecologic cancers. Data from the recent literature are reassuring about the safety of conservative management - involving the maintenance of at least the uterus and one ovary without radiation therapy - in early cervical cancers, selected early invasive epithelial tumors of the ovary, stage IA sex cord stromal tumors, and borderline tumors of the ovary whatever the stage. On the other hand, conservative management of endometrial cancers is not completely documented. Conservative management of germ cell tumors of the ovary and trophoblastic disease is standard, not an option. In addition, the field of assisted reproductive technology can be exploited when preservation of reproductive organs is not possible. Young patients presenting with gynaecologic cancers must be informed about fertility preserving options whenever applicable.