STUDY OBJECTIVE: To evaluate practice patterns in ovarian tissue cryopreservation (OTC) provision METHODS: US providers practicing or developing OTC in pediatric programs were invited to participate in a survey disseminated via the Oncofertility Consortium. RESULTS: Twenty-seven programs representing a wide geographic area responded, largely representing academic institutions (85.2%). Of these, 21 (77.4%) performed OTC at their facility, most for oncology patients receiving gonadotoxic therapy, relapsed patients, and non-oncologic patients receiving gonadotoxic therapy (95.7%, 87.0%, and 82.6%, respectively). OTC procedures were most commonly performed by pediatric gynecology surgeons (71.4%) via laparoscopic oophorectomy (90.5%) using a heat-based method (55.0%) for dissection. Most centers used an outside compensated service (50%) or a reproductive endocrinology group (45%) for processing tissue. Many (13, 61.9%) performed OTC as standard of care, and 7 utilized an institutional review board for data collection. Of the 8 centers whose OTC programs were in the planning or early stages, frequently identified barriers were lack of priority within their medical team or institution (5/8), lack of protected time (3/8), and lack of funding (3/8). CONCLUSION: OTC is commonly offered to oncology patients receiving highly gonadotoxic therapy, with pediatric gynecologists frequently involved in counseling and performing OTC. Variability exists in offering OTC to other patient populations, as well as in research practices, surgical technique, and processing. Institutions continue to face barriers in offering OTC when necessary resources are not prioritized by leadership.