Background: Advancements in cancer treatment have led to increased survival rates among young adult cancer survivors (YACS). However, these individuals face unique long-term health risks, including secondary malignancies, cardiovascular disease, and psychosocial challenges. Effective long-term surveillance strategies are critical to mitigating these risks and improving health outcomes. This scoping review aims to summarize existing recommendations for long-term surveillance of YACS, identify gaps in current guidelines, and highlight areas for future research. Methods: A scoping review was conducted using Pubmed focusing on peer-reviewed literature published between January 2015 and January 2025 that addresses post-treatment (>5 years after diagnosis) follow-up strategies for YACS. The review synthesizes recommendations across various cancer types, treatment modalities, and long-term effects. Results: The review identified 32 recommendations. Of all eligible articles initially retrieved, 169 different articles were included after screening and eligibility. Findings indicate a lack of standardized, age-specific surveillance guidelines, with most recommendations adapted from pediatric or adult oncology frameworks. Emerging evidence suggests that risk-based, personalized surveillance approaches—incorporating genetic predisposition, treatment history, and lifestyle factors—may optimize long-term health outcomes. Discussion: This review underscores the need for age-appropriate, evidence-based surveillance guidelines tailored to YACS and highlights the importance of multidisciplinary care models to support survivorship. Future research should focus on developing standardized, risk-stratified surveillance protocols and evaluating their impact on health outcomes.