En bloc resection of osteosarcoma is critical for a chance at curing the disease. In the spine, a spondylectomy should be performed to optimize the chances of survival. Involvement of two contiguous segments in the spinal column poses technical challenges, and performing a spondylectomy at the cervicothoracic junction adds another set of clinical concerns. We present a 22-year-old female with a two-level vertebral involvement at the cervicothoracic junction who underwent a two-level en bloc spondylectomy for osteosarcoma, and we describe our technique.