The clinicopathologic findings of 13 patients with ovarian pure germinomas (dysgerminomas) were studied to assess modes of therapy. The patients' ages ranged from 12 to 40 years. Ten patients had unilateral tumors clinically confined to the ovary (Stage I), including 1 patient who had an unsuspected microscopic germinoma in a normal-appearing ovary. Of those with Stage I tumors, only 1 patient developed metastases and died; however, the presence of other elements in the metastases suggested that her primary ovarian neoplasm actually may have been a malignant mixed germ cell tumor. The other 9 patients are alive without tumor after postoperative intervals of 0.3 to 29 years. Three patients had more advanced lesions (Stages II–IV) and 2 died of metastases following orthovoltage irradiation. The results of this study support the concept of individualized therapy for patients with ovarian germinomas.