Treatment for metastatic testicular tumors is based on risk stratification according to International Germ Cell Cancer Collaborative Group classification and consists of cisplatin-based chemotherapy and resection of residual tumors. The indication of residual tumor resection is sometimes controversial. The residual tumor is under surveillance without resection after chemotherapy of pure seminoma, but the residual tumor is resected after chemotherapy in most cases of nonseminomatous tumors. The Japanese Urological Association has established guidelines on testicular tumor useful for the evidence-based treatment in Japan. The indication and surgical techniques for retroperitoneal residual tumor resection after chemotherapy are discussed.