Germ-cell tumors (GCTs) are very chemosensitive and highly curable cancers. We assessed the efficacy and the safety of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) in patients (pts) with relapsing, resistant or poor-prognosis GCTs. Between January 1991 and October 2000, 15 male pts, median age 29 with GCTs - 1 seminomatous and 14 non-seminomatous - were treated with HDCT/ASCT. HDCT was given as first line therapy in 8 pts with poor prognosis GCTs and as salvage treatment in 7 pts with relapsing or refractory disease. Fourteen pts received ICE regimen. After HDCT and post-transplant surgery, 2 (13%) patients had cCR, 6 (40%) patients had pathological complete remission (pCR), 5 (33%) patients had PRm-ve and 2 (13%) patients had NR. The median follow-up was 31 months. There were no transplant-related deaths. Five patients (33%) have died of disease progression while 10 patients are alive and free of disease. The estimated-5 years relapse free (RFS) and overall survival (OS) for the fifteen patients was 67%. In conclusion HDCT/ASCT is safe and effective procedure for pts with advanced GCTs, especially if given as a first line treatment for pts with poor prognosis.