Abstract Cancer diagnoses in patients of reproductive age require balancing urgent oncological treatment with the need to preserve fertility. This FIGO Best Practice Advice outlines key considerations for fertility management in this population given the rising cancer incidence among young women and the reproductive risks posed by cancer treatments. The guidance evaluates the impact of chemotherapy, radiotherapy, surgery, and emerging therapies—such as targeted agents and immunotherapies—on gonadal function and fertility. Established fertility preservation methods, including oocyte/embryo cryopreservation, sperm banking, and ovarian tissue freezing, are detailed alongside barriers to their adoption, such as cost and limited access. Early collaborative counseling with oncologists and fertility specialists is central to addressing timelines, psychological impacts, and priorities. Post‐treatment pathways, including assisted reproduction and surrogacy, are also explored. The guidance stresses the importance of integrating fertility‐sparing interventions and fertility preservation into cancer care while advocating for equitable access to resources. Further research is needed to refine preventive interventions, evaluate long‐term outcomes, and expand options for survivors globally. By prioritizing fertility preservation within oncological care, healthcare providers can better support the holistic needs of young individuals facing cancer.