Most ovarian cancers in women over 30 arise from preexisting epithelial cells. When deciding how extensive surgical staging is needed, it is helpful to employ an intraoperative frozen section to differentiate between benign and malignant histology. Tumors from germ cell precursors make up the vast majority of ovarian masses in children and teenagers. This analysis was conducted to determine whether or not there was an agreement between the intraoperative frozen section and the final diagnosis in a cohort of children and adolescents with malignant ovarian germ cell tumors to inform the extent of surgical staging. Researchers looked through the medical histories of children and young adults with malignant ovarian germ cell tumors who participated in Children’s Oncology Group Research AGCT0132. The descriptive statistics were used to compare patients’ pathology reports with both an intraoperative frozen section diagnosis and a final paraffin section diagnosis. Each patient who met the study’s inclusion criteria had a confirmed diagnosis of malignancy, specifically a tumor of the yolk sac, choriocarcinoma, or embryonal carcinoma. Available paraffin section slides from a central pathology review were compared to final pathology findings from individual institutions. Around 60 (45.8%) out of 131 patients with ovarian germ cell tumors had diagnoses for both the intraoperative frozen section and the final paraffin section. False positive, benign tumor diagnosis (13.3%), confirmation of malignancy (61.7%), immature teratoma (16.7%), germ cell tumor not otherwise characterized (5%), and no diagnostic provided (3.3%) were the intraoperative frozen section diagnosis. Approximately 1/3rd, or 23 of 60 patients, had an improper intraoperative frozen section. In 76.3% of cases, the final pathology diagnosis at the patient’s institution agreed with the one reached after a central pathology review. According to central pathology evaluation, additional components of germ cell tumors were found in 23.7% of patients.