In contemporary stage I nonseminoma germ-cell tumor of the testis (NSGCTT) patients, increasing use of surveillance and chemotherapy, in concordance with guideline recommendations, is evident. Long-term survival rates were comparable between surveillance and active treatment (AT) patients. Among AT, retroperitoneal lymph node dissection was associated with better long-term survival outcomes. These results confirm the contemporary adherence to guideline recommendations and also confirm the safety of surveillance in patients with stage I NSGCTT. © 2019 Elsevier Inc.