OBJECTIVE Osteogenic sarcoma, also known as osteosarcoma, is a primary malignancy of the bone in which spindle cells produce osteoid. Although rare in the general population, these tumors are the most common primary malignancies of bone and the fifth most common primary malignancy of adolescence. This paper aims to provide a general overview on the presentation, radiographic evaluation, and treatment of osteosarcoma as it presents in the pediatric patient population. Particular focus is placed on the importance of a comprehensive team of physicians, including the pediatric oncologist and orthopedic surgeon, to ensure prompt diagnosis and treatment. RESULTS Survival for osteosarcoma tumor has changed significantly due to advanced chemotherapeutic regimens; current data place 5-year survival rates at 60% or greater. In addition, limb-sparing surgery has largely supplanted amputation, though the effect of this change on functional outcomes is controversial. Recent studies have shown greatly improved long-term survival data using current therapeutic regimens at tertiary referral centers. CONCLUSIONS Advancement in chemotherapeutic regimens has allowed improved survival and limb-sparing surgery in the treatment of osteosarcoma.