Abstract Cervical cancer remains a major global public health challenge, especially affecting women of reproductive age. In the context of a societal shift towards delayed childbearing, fertility preservation has become an integral component of oncologic care for early-stage disease. Radical trachelectomy has emerged as a viable fertility-sparing surgical option in carefully selected patients. This review aims to assess the role of fertility-sparing radical trachelectomy in the modern management of early-stage cervical cancer by emphasizing the evolving criteria for patient selection, advances in surgical techniques, and the critical balance between oncologic safety and reproductive potential. An analysis of the literature from the past two decades shows that radical trachelectomy, whether performed via vaginal or abdominal routes, provides excellent oncologic control for early-stage lesions. Therefore, optimal results of such a technique depend on careful patient selection along with a multidisciplinary approach in order to reduce obstetrical complications.
