Abstract: Objective To evaluate the risk factors for the prognosis of malignant ovarian germ cell tumors (MOGCT) patients after receiving fertility-sparing surgery. Methods We retrospectively analyzed the clinical data and follow-up results of MOGCT in the Affiliated Cancer Hospital of Guangxi Medical University from Jan. 1st, 1986 to Dec. 31st, 2010. Kaplan-Meier methods were used to draw survival curves and Log rank test was used to analyze the factors for survival time. Multivariate analysis including Cox regression analysis and logistic regression analysis were performed to analyze the influence of different factors on patients' fertility. Results The median age of 60 MOGCT patients was 20(9-34) years old. The median follow-up time was 41.5(2-237) months, with 4 patients replased and 9 patients died. Thirty-one patients were pregnant and gave birth to healthy babies. Univariate analysis showed that pathological type, residual size, chemotherapy, contralateral ovarian biopsy, lymph resection and omentum majus resection were related to the prognosis of patients, but inconspicuously affected on fertility. Multivariate analysis showed that only the postoperative residual tumor size influenced patients' progression-free survival (PFS) and overall survival (OS). Conclusion Postoperative residual tumor size could affect the PFS and OS of MOGCT patients. Comprehensive staging operation had inconspicuous improvement on the prognosis. MOGCT patients achieve an excellent survival and fertility after conservative surgery.