Bone tumors, encompassing both benign and malignant lesions, present significant challenges in diagnosis and treatment due to their potential impact on structural integrity and patient quality of life. Traditional surgical approaches, while effective, are associated with considerable morbidity and extended recovery periods. Over the past two decades, minimally invasive percutaneous techniques have emerged as transformative alternatives, offering precise and effective management options with reduced patient burden. This review explores the range of percutaneous interventions, including thermal ablation (radiofrequency, laser, microwave, cryoablation), cementoplasty, and advanced modalities like electrochemotherapy and magnetic resonance-guided focused ultrasound. These procedures, performed under imaging guidance such as CT or MRI, ensure precise targeting of bone lesions while minimizing damage to surrounding tissues. Techniques like hydrodissection and nerve monitoring further enhance safety, enabling treatment in anatomically complex and high-risk areas.