The prognosis of patients with relapsed or refractory mediastinal germ cell tumors is uniformly poor. There have been no reports of long-term disease-free survivors using any currently available salvage regimen. We describe a patient with primary mediastinal non-seminomatous germ cell tumor refractory to initial and salvage chemotherapy, who entered his first complete remission after surgical resection and tandem autologous bone marrow transplantation. The patient remains without evidence of disease 19 months after the first BMT.