Primary or metastatic bone tumors constitute only 1% of lumbar pathologies in patient with low back pain. Although this rate can be regarded as very low, it is obvious that initially the most of the tumor cases will be diagnosed as nonspecific low back pain, since low back pain is quite common and aformentioned malignancy is the most serious cause of the pain. Therefore the knowledge of the clinical presentation and the differential diagnosis of the neoplastic lesions in lumbar vertebrae and management of the patients according to the oncologic principles is vital. Because, if it is likely that the problem is due to a malignancy, all the diagnostic approach and treatment principles will need to continue depending on tumor management. The implementation of proper diagnosis and treatment at this stage may reduce morbidity and mortality significantly. In this review, the diagnosis and the principles of management of the primary and metastatic lumbar tumors will be outlined.