With improved survival after hematopoietic cell transplant (HCT), the number of individuals at risk for persistent or late effects is increasing. The importance of optimizing HCT survivor health and wellbeing is mounting. Fatigue is a common post-transplant symptom that impairs quality of life, yet it remains poorly understood and inadequately addressed. Multiple challenges to addressing fatigue exist, including its multidimensional presentation, multiple (often concomitant) causes, patient-clinician communication barriers, and few highly effective, evidence-based interventions that are readily implemented. To address these challenges, we sought to better describe its impact and potential causes in the post-transplant setting, fatigue-related communication with clinicians, and most effective patient-identified mitigation strategies (PIMS) for it.