OBJECTIVE: To explore the security, pregnancy outcomes, and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy (RT). METHODS: Thirty-two young patients < 40 years of age with early cervical cancer from May 2004 to July 2012 admitted in Tumor Hospital Xiangya School of Medicine of Central South University were divided into two groups based on different operation methods: vaginal radical trachelectomy (RVT) group and abdominal radical trachelectomy (RAT) group.The clinical data were analyzed by One-way Anova and multivariate Cox stepwise regression analysis. RESULTS: The operation duration, number of lymph node dissection, the height of the cervical resection, postoperative hospitalization time, incidence of vascular injury and incidence of postoperative lymphocele were respectively (250 ± 82) min, 15 ± 6, (2.31 ± 0.21) cm, (9.2 ± 2.9) d, 1/18 and 1/18 in RVT group, while (263 ± 60) min,16 ± 8, (2.32 ± 0.26) cm, (10.3 ± 3.5) d,0 and 1/14 in RAT group. There was no statistically significant difference between the two groups (all P > 0.05). The blood loss (281 ± 201) ml in RVT group was significantly lower than that in the RAT group (492 ± 320) ml (P < 0.05). The length of Vaginal hysterectomy [(2.61 ± 0.50) cm] and the width of parametrial resection [ (2.38 ± 0.36) cm] in RVT group were significantly less than those [(2.95 ± 0.10), (2.81 ± 0.22) cm] in the RAT group (all P < 0.05).The pregnancy rate between RVT group (3/18) and RAT group (2/14) were no significant difference (P > 0.05).One-way Anova analysis showed that the recurrence of early cervical cancer was related to tumor size in diameter (F = 4.911, P = 0.047), while there were no correlation with age, clinical stage, histological type and surgical approach (all P > 0.05).Multivariate analysis showed that tumor diameter size was an independent risk factor for tumor recurrence (ß = 0.259, P = 0.031). CONCLUSIONS: RT for young patients with early cervical cancer is feasible.Pregnancy outcomes after RT need to be study in the future. Tumor size in diameter is the major risk factor for tumor recurrence.