Although treatment of pediatric Hodgkin disease has become highly effective over the past 40 years, a number of patients have developed concerning late effects, such as secondary malignancies. These cancers may occur years to decades after remission and arise in the breast, thyroid, gastrointestinal tract, lung, skin, urogenital tract, and brain. There is also an increased risk of leukemia and non-Hodgkin lymphoma. Etiology and risk factors for each cancer type vary but often include certain chemotherapy agents and radiation dosages. Survivorship also varies but is often poor. The authors examined retrospective analyses of these secondary malignancies and present a summary of these findings. The information may allow clinicians to better monitor childhood Hodgkin disease survivors and reduce mortality.