Forty-two patients with mixed germ cell tumors of the ovary who were treated at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston from 1944 through 1983 are retrospectively reviewed. The median age of these patients was 16 years. The most common symptom was abdominal pain, occurring in 38 patients (90%). Detailed analysis of clinical and pathologic features is presented. Twenty of 42 patients are alive and well. Current management of mixed germ cell tumors, including the roles of second-look laparotomy and monitoring of tumor markers, is discussed. Optimal treatment consists of surgery followed by combination chemotherapy.