Minimally invasive spine surgery (MISS) has emerged as a transformative approach in the management of spinal tumors, particularly in metastatic disease. Unlike traditional open surgery, MISS minimizes tissue trauma, blood loss, and recovery time, facilitating faster initiation of adjuvant therapies. The chapter discusses traditional and minimally invasive techniques, their implementation and adaptation in clinical decision-making frameworks such as NOMS and SINS, and explores specific MISS modalities including tubular decompression, cement augmentation, percutaneous pedicle screw instrumentation, and emerging technologies such as navigation, robotics, endoscopy, and laser interstitial thermal therapy. Despite technical challenges, MISS has demonstrated safety, efficacy, and superior recovery profiles in appropriately selected cases. Technological advancements are poised to expand MISS applications further, potentially improving oncologic outcomes and patient quality of life.