The detrimental effects of cancer on male fertility are multifactorial and may be secondary to the disease process itself or to therapeutic interventions. Patients and their doctors need to be better informed about the options men with cancer have to preserve their fertility status. Sperm banking is a safe and effective means of storing sperm before chemotherapy, radiotherapy, or surgery. Advances in assisted reproductive techniques allow in vitro fertilization to occur with the injection of a single sperm into an egg (IVF-ICSI); consequently, the requirement for the amount of sperm needed from cryopreservation is minimal. Pregnancies have been achieved using IVF-ICSI with cryopreserved sperm from patients with a history of malignancy. Similarly, successful sperm retrieval using testicular sperm extraction combined with IVF-ICSI can be accomplished for men with nonobstructive azoospermia after chemotherapy. New techniques such as spermatogonial cell transplantation offer the potential to restore fertility in patients who have received radiation or chemotherapy.