Between 1972 and 1990 44 patients with ovarian tumors were treated at the Department of Pediatric Surgery of the University of Heidelberg. 27 patients (61%) suffered from tumor-like lesions: neonatal, pubertal (functional) cysts, and cysts in case of syndromes. 17 genuine tumors were found (39%): 8 germ-cell tumors, 7 cystomas respectively cystadenomas and 2 tumors of the gonadal stroma. Malignancy has been observed only in two cases: 1 malignant teratoma and 1 malignant granulosa-theca-cell tumor. 2 tumor-like lesions were caused by syndromes: Albright-McCune-Sternberg- and Stein-Leventhal syndrome: Treatment of uncommon tumors depends on their size, hormonal activity, on the syndromes with which they are associated, and on the tumor status.