Primary mediastinal germ cell tumors account for approximately 10% to 20% of all neoplasms of the mediastinum. It is generally accepted that they represent the malignant transformation of germinal elements without a gonadal focus. These tumors can be classified as teratomas, seminomas, nonseminomatous (yolk sac tumor, embryonal carcinoma, choriocarcinoma) and combined germ-cell tumors without teratomatous components. This review purposes to discuss the different primary mediastinal germ-cell tumors, their clinical presentation and options for treatment.