Germ cell tumors (GCT) are rare tumors accounting for 3% of childhood cancer, arising from the aberrant migration of common progenitor cells. GCT can arise in extragonadal and gonadal locations; extragonadal sites predominate in children. The majority of GCT are benign. Malignant GCT include yolk sac tumor, embryonal carcinoma, choriocarcinoma, gonadoblastoma, and mixed malignant GCT. Malignant GCT can develop metastases to lymph node regions and the lung. The clinical features at presentation are specific for each site. Serological tumor biomarkers such as alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (ß-hCG) are used for diagnosis and to monitor recurrence. Imaging depends of the GCT site. The aim of the imaging is to evaluate the primary tumor extent, the regional lymph nodes, the relation of the tumor with surrounding organs, and vascular structure. In case of malignant GCT, a CT chest is required to evaluate pulmonary metastasis. GCT treatment is tailored according to patient age, site of the tumor, biology, and imaging. Benign GCT are treated using surgery and observation for at least 5 years. Patients with malignant GCT should be referred to a multidisciplinary oncological team. Malignant GCT are managed in most of the cases by chemotherapy before and/or after complete surgical resection of the tumor. Chemotherapy agents employed for the treatment of malignant GCT include platinum-based chemotherapy, etoposide, and bleomycin. Prognosis depends of the tumor site and the extension of the disease. Functional outcomes including long-term follow-up are important considerations for patients and families.