Side effects of cisplatin-based chemotherapy for germ cell tumors include myelosup-pression, nephro-, neuro- and ototoxicity. These side effects as well as the pulmonary toxicity of bleomycin are dose-dependent. On the contrary, chemotherapy-associated vascular complications are unpredictable. Whereas Raynaud’s phenomenon is observed in a considerable proportion of patients, myocardial infarction, stroke, and pulmonary embolism appear to occur infrequently. The fact that some patients have been in complete remission at the time of myocardial infarction or cerebrovascular accident argues against a tumor-induced complication and is an argument in favor of a possible causative role of chemotherapy. An alteration of the clotting system and vascular smooth muscle tone as well as an endothelial cell damage are discussed to be pathogenetic mechanisms. Pulmonary embolism, on the contrary, seems to be more frequently associated with inferior vena caval obstruction by tumor masses. Presently there is a debate whether, apart from rare acute vascular events, chemotherapy for testicular cancer leads to a long-term alteration of lipid profile and thereby eventually increases cardiovascular risk.