Testicular cancer (TC) is the most common solid cancer in young adults between 14 and 44 years of age, with an overall survival rate of approximately 95%. Forty-two percent of all patients with advanced testicular cancer after first-line chemotherapy maintain residual tumor masses. Residual tumor resection (RTR) in these cases plays a crucial role in a multimodal treatment. Over the last two decades, treatment indications for tumor resection have changed. While patients with seminomatous tumors rarely require any operative intervention after chemotherapy, RTR is primarily reserved for NSGCT patients. Due to the complexity of the operation with potential adjunctive procedures, this kind of surgery should only be performed in high-volume referral centers. Additional surgical interventions, such as vascular interventions including caval and aortic resection with grafting, nephrectomy, or partial bowel resection might be required. Hence several complications can be seen in the peri- and postoperative course. This chapter aims to describe indications for residual tumor resection, the operative technique, including adjunctive procedures, and the management of the most common peri- and postoperative complications.