Metastatic disease of the pelvis is common in advanced cancers, most notably breast, prostate, lung, kidney, and thyroid malignancies. The pelvis, being a key structural and weight-bearing part of the skeletal system, is particularly vulnerable to metastatic involvement due to its extensive vascularity and marrow content. When metastasis affects the pelvic bones, it often leads to debilitating symptoms, including severe pain, compromised mobility, and pathologic fractures. In certain cases, surgical intervention is warranted to manage these issues and improve patient outcomes. The primary goal of surgery in the management of pelvic metastasis is not curative but rather to achieve palliation, pain relief, stabilization of skeletal integrity, and preservation or restoration of function. Surgical approaches to pelvic metastases are complex and require careful consideration of the disease extent, patient factors, and oncological prognosis. This chapter provides a comprehensive overview of the surgical approaches to treating pelvic metastasis, covering anatomical considerations, indications for surgery, preoperative planning, surgical techniques, postoperative care, and outcomes.