Introduction: Redo retroperitoneal lymph node dissection (redo surgery) for the treatment of germ cell tumors is an uncommonly performed procedure. We describe clinical characteristics and outcome of patients with disease requiring redo surgery for recurrence or residual retroperitoneal disease. Material and methods: The INCan germ cell tumor surgical database was reviewed from January 2007 to December 2012 and clinical features of patients subjected to re-operative retroperitoneal surgery (redo surgery) for germ cell tumors were individualized. Preoperative evaluation, histopathology, morbidity, and technical aspects of this procedure, which is a critical part of the management of germ cell tumors, are described. Disease-specific survival was estimated using the Kaplan-Meier method. Results: A total of 20 patients were identified who underwent 27 redo surgeries after post-chemotherapy retroperitoneal lymph node dissection. The most common site of disease in the redo surgery was the para-aortic region. The most frequent histologic finding at time of redo surgery was teratoma. The median interval to redo surgery was 12 moths (P25 8.5-P75 14.75). The overall intraoperative complication rate was 18% and median length of hospital stay was three days. The five-year disease-specific survival rate was > 55%. Disease-specific mortality for patients who underwent redo surgery was 40% (n = 8). Conclusion: Redo surgery is an integral component of the management of germ cell tumors in cases of retroperitoneum recurrences or failures; it is the last opportunity for cure. Clinical outcomes after repeating retroperitoneal surgery depend on re-operative histology.