Gynecological cancers comprise more than 30% of all cancer mortality in women worldwide and are responsible for an estimated 40% of all cancer incidence. Recently, there has been a significant surge in the prevalence of cancer diagnosis occurring at an earlier stage of life. As the number of cancer survivors increases, the preservation of fertility in women becomes critically important for patients and their families. In light of the fact that surgical excision of the reproductive organs is the primary cause of infertility, the optimal course of action is to modify the surgical approach. We conducted a literature review pertaining to provide a comprehensive summary of the presently accessible treatment approaches for preserving fertility in gynecologic malignancies, along with an analysis of their obstetrical and oncological outcomes.