Newly diagnosed cancer patients are inconsistently counseled about the infertility risks associated with oncologic treatments and the fertility preservation options currently available. Oncology nurses are placed in a unique position to introduce fertility topics with oncology patients; however, several barriers prevent counseling on this subject. The purpose of this paper is to determine the knowledge gaps, barriers, and facilitators of counseling newly diagnosed reproductive-aged cancer patients about fertility issues before cancer treatments among oncology nurses. An anonymous web-based, cross-sectional survey was accessed from August 2018-November 2018 and completed by oncology nurses employed in the medical oncology and infusion centers of a large multicenter cancer institution. The survey consisted of five elements: study consent, demographic information and general fertility questions, the American Society of Clinical Oncology (ASCO) 2013 clinical practice guideline questions, a validated knowledge tool to assess general fertility knowledge, and a validated oncology fertility preservation survey to determine barriers and facilitators to counseling patients about fertility issues. Thirty-eight participants completed the survey in its entirety, and the collected data were reviewed and analyzed. The majority of participants were full-time, Caucasian oncology nurses with an oncology experience of 1-5 years or 6-10 years. All of the participants were female. The majority of oncology nurses reported that they were unfamiliar with the clinical guidelines related to fertility preservation and oncology patients. The average baseline knowledge score using the validated knowledge tool was 7.1 (out of 13 questions). The higher domain scores in self-awareness, confidence, and external barriers from the fertility preservation survey indicated that self-perceived barriers and self-related preparedness hindered oncology nurse counseling on fertility topics. The findings suggest that oncology nurses would benefit from comprehensive training about fertility issues that impact oncology patients to adequately and confidently counsel these patients on this topic. Presenting these topics to patients who are interested in future fertility and those that are physiologically stable enough to pursue fertility preservation options will allow them the opportunity to make informed decisions about their future fertility and quality of life before possible sterilizing treatments.