Background: Pediatric oncologists are responsible for facilitating the transition of childhood cancer survivors to risk based adult focused care. This study describes transition practices, perceived barriers to transfer to adult care, and identifies areas for potential intervention. Methods: An electronic survey of U.S. members of the Children’s Oncology Group; 492/1449 responded (34%) and 347/492 (71%) met eligibility (pediatric oncologist caring for outpatients > age 11 years). Results: Of the 347 respondents, 50% are male, median years in practice 10 (range 5-22), 82% are at an academic institution, 37% a free standing children’s hospital, and 5% are board certified in adult medicine. Almost all continue to care for patients up to age 21 years (96%), 42% report continuing to take care of adult patients over age 25 years, 16% over age 30 years, and only 8% over 40 years. While 66% of oncologists report providing transition education to their patients, the majority report also having other staff provide this education (89%). Compared to the 147 (42%) who care for adult patients older than 25 years, those who do not were more likely to endorse specific criteria for transfer including survivors’ age (p=0. 006), pregnancy (p=0.014), marriage (p=0.010), college graduation (p=0.006), and substance use (p=0.036). Most oncologists identified barriers to transfer to adult care including patients’ attachment to provider (91%), parents’ attachment to provider (90%), lack of knowledgeable adult providers (86%), cognitive delay (81%), and unstable social situation (80%). However, oncologists who continue to care for patients older than 25 years are more likely to perceive parents’ attachment to provider (p=0.037) and patients’ unstable social situation as barriers to transfer (p=0.044). Conclusions: Most pediatric oncologists report transferring adult childhood cancer survivors to adult care and providing transition education to their patients. Those who continue to care for survivors as adults are more likely to perceive psychosocial needs as barriers to transfer. Transition practices that address developmental and psychosocial challenges might facilitate successful transfer of childhood cancer survivors to adult care.