Combination chemotherapy, often in conjunction with surgery and external radiotherapy, is utilized in most children with tumors of the genitourinary tract. These chemotherapeutic agents are capable of causing a variety of delayed toxicities. Common late complications include cardiotoxicity associated with prior exposure to an anthracycline, pulmonary dysfunction, infertility in males due to prior therapy with alkylating agents, and secondary leukemia in individuals treated with epipodophyllotoxins.