In geriatric patients, metastases are by far the most frequent malignant bone lesion. There are several imaging modalities available to detect and characterize bone tumors in the elderly. Bone scintigraphy, radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and hybrid imaging techniques all have specific uses and indications depending on the biological nature of the primary tumor and their ability to visualize biomarkers of bone metastases. Although radiography is still the initial imaging test of choice for an elderly patient presenting with a suspected bone tumor, technological innovations in the last decades have advanced the role of other imaging modalities for assessing bone tumors. These include advances in CT, MRI, and hybrid imaging techniques that combine two existing modalities, providing clinicians with diverse tools for bone tumor imaging applications. In this book chapter, we review the state-of-the-art imaging techniques and advocate multidisciplinary management mainly based on collaborations between orthopedic surgeons, pathologists, oncologists, radiotherapists, and radiologists aimed at improving patient outcomes. Radiologists play a key role in this multidisciplinary approach both to “choose imaging wisely” and in decision-making through correlating the tumor entity, the tumor biology, the impact on the surrounding tissues and progression, as well as the overall condition of the patient. This precision medicine approach advocates choosing the best patient-tailored imaging plan, i.e., a “choose imaging wisely” strategy throughout the initial diagnosis, minimally invasive treatment procedures, and follow-up care plans.