In general, the 5-year survival for patients with most types of sarcomas has doubled since the 1970s; improved chemotherapy, surgery, radiographic, and pathologic techniques all have contributed to this accomplishment. The 5-year survival for patients with osteosarcoma, like most sarcomas, is approximately 60% when the disease is treated with appropriate chemotherapy, surgery or radiation therapy. The details of treatment are complex and many controversies remain. The initial workup, biopsy, chemotherapy, and surgery should be delivered by a center with experience in the treatment of sarcomas.