Osseous metastatic disease involving the elbow is exceedingly rare, accounting for only 1% of malignant lesions involving this area. Treatment of lesions in this area requires multidisciplinary involvement as it often entails systemic/targeted therapy, radiation, and possible operative intervention. The major surgical options utilized for treatment of these lesions include plate fixation with or without intralesional treatment of the lesion, or, in the appropriate clinical setting, resection and reconstruction with modular endoprostheses. The elbow joint poses unique challenges due to limited soft tissue coverage and the proximity of critical neurovascular structures. As such, complications after surgical treatment can be high—approaching up to 25% in some series. Thus, the management of these lesions needs to account for patient-specific characteristics, tumor histology, and sensitivity to adjunct treatment modalities, thereby ultimately necessitating multidisciplinary involvement to optimize functional and oncological outcomes.