Pediatric ovarian tumors represent a rare but clinically important category of gynecologic conditions, comprising approximately 1-2% of all childhood malignancies and about 5% of pediatric abdominal masses. While most are benign, a meaningful percentage can be hormonally active, raising diagnostic and therapeutic challenges. Due to nonspecific symptoms such as abdominal pain or distension, early diagnosis is often delayed, potentially compromising fertility preservation and long-term outcomes. A multidisciplinary, age-specific approach is essential to optimize management.