Gestational trophoblastic disease (GTD) encompasses a group of rare disorders ranging from pre-malignant to malignant conditions. Today, the management of GTD in Europe has evolved into a centralized approach which is crucial for the best outcomes. To investigate the centralized approach, we conducted a literature search on the PubMed/MEDLINE database and others such as SCOPUS, Google Scholar, Cochrane Library, January 2025. Additionally, we searched the official websites of European countries and the EU for information about European Reference Networks (ERNs) and national centers for GTD. We identified three phases in the centralization process of GTD management in Europe. The initial phase involved local hospitals and the development of the concept of centralized and specialized treatment for GTD. In the second phase, national centers for GTD were established. Finally, the creation of ERNs brought these national centers together. ERNs use advanced and multi-level tools of health communication. As conclusion, the current approach to managing GTD in Europe emphasizes the centralization of treatment and follow-up, with national centers and ERNs serving as the core components of this strategy. This approach may be an example of the best management of GTD for the world.