Intra-operative pathological assessment using analysis of frozen sections has been a valuable and rapid tool in general surgical pathology to guide the surgeon in decision-making but has a less prominent role in soft tissue tumors. Frozen sections of a mass can be obtained in the intra-operative stage to determine the nature of a lesion in order to establish a provisional diagnosis when a lesion is unexpectedly encountered during surgery. In addition, intra-operative evaluation of margins of conventional surgical specimens can be helpful when in doubt between R0 or R1, or as a part of Mohs microsurgery to guide the decision on the extent of surgery. Moreover, frozen sections can be used to evaluate the adequacy of obtained material in case of a diagnostic procedure. General challenges for frozen section analysis include technical issues, sampling error and the impossibility of using immunohistochemistry. In addition to these limitations, soft tissue tumors represent a broad spectrum of different diseases with considerable morphological overlap, and due to their rarity pathologists often have limited exposure, reflecting the lower diagnostic accuracy compared to epithelial tumors. However, occasionally, with specific indications, intra-operative frozen section consultation might be considered as an aid to guide intra-operative decision-making.