Metastasis to the bone represents a frequent complication of visceral cancers, most commonly in patients with advanced breast, prostate, and lung cancer. More than 50% of patients with advanced breast or prostate cancer have identifiable bone metastasis, and 30% to 40% of patients with non-small-cell lung cancer ultimately develop metastases to bone. Most tumors preferentially metastasize to the axial skeleton, targeting the vertebrae, pelvis, proximal ends of long bones, and skull. Skeletal complications as a result of these metastases are widely recognized to increase mortality and decrease quality of life--specifically the loss of mobility, independence, and social functioning of a patient. Advances in understanding the mechanisms of metastasis to bone, the resulting physiologic disturbances that take place, screening, diagnosis, and availability of better treatment options are advancing clinicians' abilities to combat this devastating problem.