OBJECTIVE: Various treatments of brain tumors may affect ovarian and endocrine function, resulting in a plethora of disorders. The purpose of this study was to analyze the impact of brain tumors on ovarian health and endocrine function in female childhood survivors. STUDY DESIGN: Ovarian and endocrine function in 222 childhood cancer survivors diagnosed with brain tumors at a tertiary comprehensive cancer center between 1997-2008 was retrospectively analyzed and compared. RESULTS: An equal proportion of childhood survivors of brain tumors (N = 39) and survivors of non-brain tumors (N = 183) developed ovarian dysfunction. Of those children older than 13 years, menstrual cycle irregularity (36% of brain tumor survivors vs. 21% of non-brain survivors, p = 0.3), amenorrhea (22% vs. 22% respectively, p = 0.9), and elevated FSH levels (40% vs. 50%, p = 0.9) were not statistically significant between the two groups. Brain tumor survivors experienced increased risk of endocrine disorders, such as precocious puberty (13% vs. 2%, P = 0.005), delayed puberty (8% vs. 1%, P = 0.0178), and hypopituitarism (10% vs. 1%, P = 0.01). Furthermore, children with brain tumors were significantly more likely to develop multiple endocrine disorders at the same time (31% vs. 7%, P = 0.001 for two endocrine disorders and 23% vs. 2%, P= 0.0001 for three or more endocrine disorders) and were more likely to visit with an endocrinologist (46% vs. 14%, p = 0.0001), when compared to non-brain tumor cancer survivors. While all brain tumor patients were seen at the multi-specialty neuroncology clinic, they were less likely to attend survivor clinic (4% vs. 28%, p = <0.003), and more likely to receive assistance from survivor clinic staff (97% vs. 57%, p = 0.001), when compared to non-brain tumor cancer survivors. CONCLUSIONS: Female pediatric brain tumor survivors are equally likely to experience ovarian insufficiency when compared to non-brain tumor survivors, but were significantly more likely to suffer coexistence of multiple endocrine problems.