Advancements in the multimodality treatment approach have significantly enhanced the quality of life and survival of patients with bone sarcomas over the past two decades. In over 90% of patients, resection is performed instead of amputation, and the majority of patients with soft tissue and bone sarcomas can be cured through the use of limb-sparing surgery in conjunction with chemotherapy and radiation therapy. The 5-year survival rates of bone malignancies have increased from approximately 50% in 1970 to a range of 75–80% in the adolescent age group as a result of remarkable achievements in multimodality management. It is imperative to possess a comprehensive comprehension of the fundamental biology and pathology of soft tissue and bone tumors in order to effectively plan their treatment. This chapter examines the clinical presentation of bone malignancies, the principles of surgical management, numerous diagnostic modalities, and staging [1].