Germ cell tumours are among the most curable solid cancers and have become a model for the multimodality approach in oncology. The experience of two institutions in Hong Kong involving 149 Chinese patients with testicular germ cell tumours and 10 patients with mediastinal germ cell tumours was reviewed and the overall results were found to be comparable with the global experience. Treatment strategies suitable for the local population are discussed. The earlier identification of patients with metastatic non-seminomatous germ cell tumours who have a poor prognosis, may be important in selecting patients for more intensive treatment such as high dose chemotherapy. With mediastinal germ cell tumours, survival is poorer and improved treatment results may only be possible with increased understanding of the biological abnormalities involved. An integrated multimodality approach to the diagnosis and treatment of this disease is vital to attain optimal management. For these reasons, it is recommended that all patients with germ cell tumours be referred to cancer centres where cross-specialty expertise and experience are available to manage these patients.