Background: Ovarian tumors true incidence in young females is not known. Objective: To review the incidence of ovarian tumors in children and adolescents and their clinical presentation in these patients in Aswan city and district as representative of Egypt. We also characterized the pathological features of these ovarian tumors and tailor the best management of these tumors in young females(less than 18 years old). Patients and Methods: Thirty-six malignant ovarian tumors in females <18 years were followed in Surgery Department, Aswan University hospital. Different aspects were analyzed regarding clinicopathological data, investigations and treatment. Follow up by clinical examination, CT scan and laboratory profile was done every 3 months in the first year, then every 6 months in the second year and then yearly. The follow up period for each case was calculated from end of the treatment to the last follow up visit. Results: Thirty-six young female patients with malignant ovarian tumors were recorded, which represented 18% of total pediatric malignancy throughout the 3 years of the study. All patients underwent primary surgical resection through laparotomy. Unilateral salpingo-oophrectomy (USO) was performed. AFP was the commonest elevated marker in 6 cases and CA125 in 4 cases. The most common symptom was abdominal mass in 14 cases and most common tumor was yolk sac tumor 14 cases. All cases received chemotherapy adjuvantly except the four cases stage 1. However, due to progression and recurrence, six cases required further chemotherapy lines. Conclusion: Yolk sac tumor and dysgerminoma are the commonest pediatric malignant ovarian tumors in this study. Multimodality treatment is essential. Fertility preservation should be respected. The advanced stages have the highest mortality.