Background: Testicular germ cell tumors (tGCTs) are rare but are highly curable, resulting in a large cohort of long-term survivors. The primary aim of most follow-up programs after initial treatment is to detect recurrence, which emphasizes regular imaging and measurement of serum tumor markers. Most relapses occur in the first two years after treatment. However, many of these patients also experience survivorship issues beyond the two-year timepoint which are underrecognized in the clinical setting and underreported in clinical literature. Methods: We retrospectively reviewed clinical documentation across a cohort of tGCT patients in St Bartholomew’s Hospital who received adjuvant treatment (n=171), treatment for metastatic cancer (n=325) and those who underwent surveillance only (n=225) from 2011 and 2021. Only patients with a minimum follow-up of 5 years were included. Data was collected between Year 3 to Year 10 after initial treatment, ie only after two years of surveillance were completed. The frequency in which the following terminology/symptoms appeared in clinical documentation was recorded: relapse, endocrinology (a hormone problem including, but not included to hypogonadism/diabetes/thyroid dysfunction), lifestyle advice (eg weight management), blood pressure, cholesterol, psychology, fertility and other problems. Each reported issue was only recorded once per patient for this study. Results: Relapse rates were 0-0.75% annually (0% adjuvant, 0.7% metastatic, 0.75% surveillance). Total relapse rates beyond the two year time point, per group, were 0% in the adjuvant group, 5.8% in the metastatic group, and 6.0% in the surveillance group. Of the patient group who received treatment, significantly more reported endocrinological issues (7.0% average annually in the adjuvant group vs 4.2% metastatic vs 0.1% surveillance). Issues relating to blood pressure were equally reported (5.5% average annually in adjuvant vs 2.95% in metastatic vs 2.60% in surveillance) as were cholesterol (4.7% average annually in adjuvant vs 2.2% in metastatic vs 2.2% in surveillance). Fertility issues were more commonly reported in the group of patients who received treatment for metastatic cancer (2.4%) as opposed to those who received adjuvant treatment(0.5%) and surveillance only (0.7%). Conclusions: Relapse rates in our cohort of patients are low and consistent with previous studies. However, we highlight multiple survivorship issues for patients who have received treatment – particularly issues pertaining to endocrinological issues and fertility. These results suggest the need to incorporate monitoring of survivorship issues into our routine follow-up to improve patient experiences and outcomes. We suggest that a specialist clinic focused on long-term survivorship issues be established to better address the needs of this patient population.