During the past several decades, survival rates of many childhood cancers have risen at a remarkable pace. The ever-growing population of cancer survivors is at potential risk for developing a broad spectrum of adverse outcomes relating to cancer diagnosis and treatment, including infertility, adverse pregnancy-related outcomes, and health problems of offspring. Unfortunately, these topics have not been extensively studied, particularly among pediatric cancer survivors receiving more recent therapies. Based on the current literature, therapy for childhood cancer, in general, does not appear to have a significant impact on pregnancy outcomes and on the health of offspring of childhood cancer survivors. Additional investigations, incorporating more rigorous designs, need to be conducted to further address potential long-term risks relating to birth outcomes, including birth weight. Studies currently underway to evaluate the incidence of and risk factors for birth defects, occurrence of cancer, and other serious health-related outcomes will provide valuable information to guide researchers, clinicians, and survivors and their families.