This study systematically assessed the health outcomes of 1713 adult survivors of childhood cancer, median age 32 years, who were enrolled in the St. Jude Lifetime Cohort Study. The prevalence of adverse health outcomes was highest for pulmonary, auditory, endocrine-reproductive, cardiac, and neurocognitive functions, with 65.2%, 62.1%, 62.0%, 56.4%, and 48.0% prevalence, respectively. The attributable fractions for endocrine-reproductive disorders were highest (88.4%), while conditions like hypertension, dyslipidemia, and obesity had lower attributable fractions. The cumulative prevalence of any chronic health condition was 95.2% by age 45 years, and 80% for serious, life-threatening, or disabling conditions. The study highlights the need for ongoing health monitoring and intervention for this population, as many previously undiagnosed problems were identified.This study systematically assessed the health outcomes of 1713 adult survivors of childhood cancer, median age 32 years, who were enrolled in the St. Jude Lifetime Cohort Study. The prevalence of adverse health outcomes was highest for pulmonary, auditory, endocrine-reproductive, cardiac, and neurocognitive functions, with 65.2%, 62.1%, 62.0%, 56.4%, and 48.0% prevalence, respectively. The attributable fractions for endocrine-reproductive disorders were highest (88.4%), while conditions like hypertension, dyslipidemia, and obesity had lower attributable fractions. The cumulative prevalence of any chronic health condition was 95.2% by age 45 years, and 80% for serious, life-threatening, or disabling conditions. The study highlights the need for ongoing health monitoring and intervention for this population, as many previously undiagnosed problems were identified.