Johansen G, et al. - All women ages 18–40 treated with either fertility-sparing surgery (FSS) or radical surgery (RS) for stage I non-epithelial ovarian cancer (NEOC0 between 2008 and 2015 were recognized via the Swedish Quality Register for Gynecological Cancer in order to contrast the oncologic outcome of women who underwent FSS vs RS for treatment of NEOC in a prospective, nationwide, population-based study and report on the reproductive outcomes in women following FSS. A total of 73 women aged 18–40 received a stage I NEOC diagnosis. The majority underwent FSS (78%; n = 57). Irrespective of the surgical approach, the 5-year OS rate was 98%. In women treated with FSS, in contrast with RS, no statistical variations between OS and PFS rates were noted. Recurrences were more common following RS vs FSS. Following FSS, 11 women gave birth to 13 healthy children (all superfetated naturally). Moreover, in the cohort, 12% of the women acquired infertility and received ART treatment (n = 7). Hence, in young women with early-stage NEOC, FSS is not related to worse oncologic outcomes compared with RS. With an OS of 98%, the prognosis was great in both groups. Moreover, in women treated with FSS, natural fertility was sustained and only 12% needed ART treatment.