Biopsy is a key step in the diagnosis of bone and soft tissue tumors. An in
adequately performed biopsy may fail to allow proper diagnosis, have a nega
tive impact on survival, and ultimately necessitate an amputation to accomp
lish adequate margins of resection, poorly performed biopsy remains a commo
n finding in patients with musculoskeletal tumors who are referred to ortho
paedic oncology centers. The principles by which an adequate and safe biops
y of musculoskeletal tumors should be planned and performed are reviewed, a
nd the surgical approach to different anatomic locations is emphasized.