This chapter discusses fertility preservation and reviews the recent evidence on the pathophysiology of chemotherapy/radiotherapy-induced gonadal toxicity and the recent data on the indications and the outcomes of techniques used for fertility preservation in female cancer patients. The exact incidence of premature ovarian failure (POF) following chemotherapy is difficult to establish since many factors contribute to ovarian failure. Several reproductive-age malignancies afflicting pelvic organs can be cured with radiotherapy. These include cervical, vaginal, and anorectal carcinomas, some germ cell tumors, Hodgkin's disease, and central nervous system tumors. A wide variety of strategies have been assessed for fertility preservation in females which includes chemoprotection, ovariopexy, and assisted reproductive technologies. Keeping the testicles outside the field of radiation or being shielded has been shown to be an effective strategy to prevent radiation-induced testicular damage. Semen cryopreservation and testicular tissue cryopreservation are fertility preservation measures in male using assisted reproductive technologies.