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Childhood cancer survivors (CCS) are at risk for health-related and social challenges that can extend far into adulthood. However, CCS' trajectories are heterogeneous. As a potential influencing factor, the present work investigated adult romantic attachment in conjunction with their relationship perceptions and experiences and help-seeking behavior. CCS (N = 633, aged 24-49 years) were recruited in cooperation with the nationwide German Childhood Cancer Registry (GCCR). Participants underwent a comprehensive medical examination at the study centre. Validated self-report questionnaires (including the ECR-RD8, PHQ-9, F-SozU K6, UCLA 3-item loneliness scale) and further items regarding help-seeking behavior were applied. Adult romantic attachment orientations were substantially related to CCS' relationships in adulthood: Both more attachment anxiety and avoidance were linked to higher loneliness (r = 0.471, p < .001; r = 0.320, p < .001) and lower perceived social support (r = -0.349, p < .001; r = -0.300, p < .001). While 20.2% of CCS reported a need for psychosocial support, only 7.3% reported currently using a professional support offer. Lastly, attachment orientations also played a role in whether CCS voiced such a need when experiencing distress: Attachment anxiety moderated the relationship between suicidal ideation and the expression of a need for support, diminishing help-seeking. The findings emphasize the importance of integrating attachment-informed approaches in the long-term care of CCS. Tailored interventions addressing the interpersonal and emotional needs shaped by attachment styles could enhance resilience and mitigate barriers to seeking psychosocial support.