Cisplatin-based chemotherapy considerably improved the outcome of patients with metastatic germ cell tumors. Apart from Raynaud's phenomenon, a frequent side effect, vascular toxicity associated with chemotherapy for testicular cancer, has not been described precisely. Although major vascular complications such as myocardial infarction, stroke and pulmonary embolism seem to occur infrequently, they raise concern with regard to the safety of chemotherapy. Also, potential late vascular toxicity has to be taken into account. Whereas a cause and effect relationship is probable for some vascular events following chemotherapy, some cases may represent coincidence or may be disease related. Presently, the very low incidence of major vascular events should not enter into therapeutic decisions.