Metastatic bone disease (MBD) causes significant worsening of patient quality of life (QoL) and prognosis. As the number of patients with MBD continues to increase, management of MBD has evolved, now focusing on prevention of skeletal-related events (SREs) and restoration of patient function. For this, emphasis has been placed on multidisciplinary care. To select the optimal treatment, accurate prognosis estimation using performance scores is critical. In addition, precise prediction of fracture risk is imperative. It is important to stratify the extent of the disease, as patients with solitary metastases or oligometastases may not receive the same treatment as those with diffuse lesions. Current treatment relies on a combination of systemic treatments, including antineoplastic and antiresorptive agents, and local treatments, such as radiation therapy (RT), percutaneous interventions, and open surgery.