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Cancer survivorship often includes reproductive health concerns (e.g., fertility potential and treatment-related health problems) that elevate psychological distress. Partner support is a key, modifiable resource linked to better adjustment, yet its pathway of influence is not fully understood. To test whether partner support mediates and/or moderates the association between reproductive health concerns and psychological distress among female cancer survivors. A cross-sectional study was conducted with 202 married female cancer survivors (ages 20-49) attending the oncology departments of Tanta University Hospital, Egypt. Validated measures included the Reproductive Concerns after Cancer Scale, Partner Support Scale, and Kessler Psychological Distress Scale. Higher reproductive concerns related to greater distress (r = 0.517, p < 0.01). Partner support correlated negatively with reproductive concerns (r =  - 0.446, p < 0.01) and distress (r =  - 0.471, p < 0.01). Adding partner support improved prediction of distress (Model 2, R² = 0.345); partner support was a significant negative predictor (B =  - 0.364, p < 0.001). Mediation was supported: Reproductive Concerns after Cancer Scale → distress total effect B = 0.4212 (p < 0.001); direct effect B = 0.3124 (p < 0.001); indirect effect via partner support B = 0.1088, 95% CI [0.0617, 0.1613]. Moderation was not supported (interaction B≈0.000, p = 0.998). Conclusions: Reproductive concerns are associated with elevated psychological distress. Partner support partially mediates yet does not moderate this relationship, indicating a protective, indirect effect on distress. Implications for Practice: Integrate structured partner-involved education and counselling into survivorship care to reduce distress linked to reproductive concerns (confirmed need). Screen routinely for reproductive concerns and perceived partner support and refer dyads to targeted psychosocial interventions. Training for nurses should prioritize communication about fertility/health concerns and techniques to engage partners effectively.