Background: Primary malignant mediastinal germ cell tumors (PMMGCT) are exceedingly rare, accounting for 1-2% of germ cell tumors. The objective of this case report is to highlight the severity and unique characteristics of this tumor. Case Report: A young, active 33 year old male presented to a community emergency department with flu-like symptoms and hemoptysis continuously for one month. Work-up noted a large anterior mediastinal mass with erosion into the sternum. Biopsy revealed a non-seminomatous germ cell tumor, with primary malignant origin in the mediastinum. Chemotherapy was initiated, which the patient has tolerated well during his first few rounds of treatment. Conclusion: PMMGCTs are rare and aggressive tumors with variable response to chemotherapy. Extensive surgery has been offered for those with resistant factors, with more complications.