Malignant pelvic tumours in adolescents are rare. Cancers most commonly associated with adolescent women are ovarian germ-cell tumours, ovarian stromal tumours, genital rhabdomyosarcomas and cervico-vaginal clear-cell adenocarcinomas. The incidence of the last of these has reduced with the abandonment of diethylstilbestrol (stilboestrol) therapy in pregnancy. With sexual activity among adolescent women increasing, the incidence of cervical cancer and gestational trophoblastic tumours is rising. Treatment for pelvic cancers in adolescence should be in a multidisciplinary setting and in most cases surgery should be conservative with the aim of preserving sexual and reproductive function. With a few notable exceptions, the prognosis for most malignant pelvic tumours that occur in adolescence is good and treatment is with curative intent.