Advances in the diagnosis and treatment of childhood, adolescent and adult cancer have increased the life expectancy of premenopausal women with the disease. Oncological indications for ovarian tissue cryopreservation are summarized. Patients undergoing oophorectomy for prophylaxis may potentially benefit from ovarian cryopreservation. There have been numerous reported cases of autotransplantation of cryopreserved ovarian tissue, either to an orthotopic or heterotopic site. Approximately one third of young women exposed to chemotherapy develop ovarian failure. It is our ethical responsibility to propose cryopreservation of ovarian tissue to all adolescents and young women under institutional review board (IRB) protocols having to undergo chemotherapy with alkylating agents. Research programs need to determine whether active angiogenesis can be induced to accelerate the process of neovascularization in grafted tissue, if isolated human follicles can be grafted or, indeed, if microvascular re-anatomosis of an entire cryopreserved ovary is a valuable option.