Tumours of the scapula present a diagnostic and therapeutic challenge due to the complex anatomy of the shoulder girdle and the relative infrequency of primary involvement. Despite the shoulder girdle being a common site for bone and soft tissue tumours, the scapula accounts for a minority of these cases, with reported incidence rates up to 20%. The flat and intricate structure of the scapula often makes diagnosis and staging more challenging than in long bones and appendicular skeleton, necessitating a multimodal imaging approach. Preoperative imaging must precisely delineate tumour extent, its relationship to vital neurovascular structures, and involvement of adjacent joints and musculature. Given that primary scapular tumours are more likely to be malignant than benign, and can often present with unspecific symptoms, and masquerade as benign conditions, a high index of suspicion is required. This chapter discusses the relevant tumour features, radiological findings, and surgical considerations for scapular lesions to aid in early diagnosis and treatment planning.