To find cumulative recurrence rate and risk factors for recurrence in young women with mature cystic teratoma (MCT). Patients aged 10-29 years with MCT confirmed by their first ovarian surgery between 2000 and 2018 were included in the study. To rule out residual lesions, only patients with no MCT-suspected lesions on imaging within 1year after surgery were included in the study. Patients who had not undergone imaging tests from 1year after surgery or had other findings on biopsy were excluded. The present study included 372 (84.2%) patients with cystectomy and 70 (15.8%) patients with oophorectomy. The 5-year cumulative recurrence rates for each patient group were 11.2% and 20.3%, respectively. The hazard rate of recurrence was higher in the oophorectomy group than the cystectomy group within 5 years after surgery. Large tumor size (hazard ratio [HR] 2.59; 95% confidence interval [CI] 1.11-6.08) and bilaterality (HR 2.65; 95% CI 1.27-5.52) were significant predictors of recurrence in the cystectomy group. The 5-year cumulative recurrence rate after surgery in young women with ovarian MCT was 11.2% in the cystectomy group and 20.3% in the oophorectomy group. Risk factors for recurrence after cystectomy were large tumor size and bilaterality.