Multimodal therapy of tumor patients with osseous metastases is an interdisciplinary task. The surgical treatment requires optimal integration, in terms of timing and extent of the procedure, into the overall treatment plan. In addition to surgery, modern therapeutic approaches include systemic chemotherapeutic, hormonal and immunological therapy, radiotherapy, and other drug therapy (i.e. biophosphonates). We use classical stabilization methods with plates and bone cement or intramedullary nailing and also new implants with angular stability like an internal fixator and modular endoprothesis systems in operative therapy. Such stabilizing systems allow bridging of tumor defects in almost all parts of the skeleton. The ultimate goal of any treatment and especially of operative intervention is a mobile patient with little or no pain and a good quality of life.