The shoulder girdle (including the proximal humerus, scapula, and clavicle) is a relatively common location for metastatic disease, and the management options vary based on patient- and tumor-related factors. Non-operative management does have a role for disease involving the shoulder girdle, especially for the scapula and clavicle; however, disease involving the proximal humerus is often managed with surgery. There is currently no “gold standard” surgical option, with pros and cons to each, with options for fixation and endoprosthetic replacement. The purpose of this chapter is to provide a guide to the work-up and surgical management of these patients. It is important to involve a multidisciplinary team of medical oncology, orthopedic oncology, and radiation oncology in developing the appropriate plan for the management of these patients.