Extremity soft tissue sarcomas are rare malignant tumors that require a complex and personalized approach to treatment. Surgery remains the mainstay of treatment, with limb-sparing surgery being preferred over amputation whenever possible. The extent of surgery is determined by the size and location of the tumor, as well as the patient`s overall health and functional goals. Preoperative imaging is important to accurately assess the extent of the tumor and determine the feasibility of limb-sparing surgery. Radiation therapy is often used in conjunction with surgery to reduce the risk of local recurrence. It may be given before or after surgery, depending on the tumor characteristics and the extent of surgery. Systemic therapy, including chemotherapy and targeted therapy, may be used in certain cases to shrink the tumor before surgery or to treat metastatic disease. Chemotherapy is typically used for high-grade tumors or when there is evidence of metastasis. Targeted therapy may be used for specific subtypes of soft tissue sarcoma that have mutations or overexpression of certain genes. The decision to perform limb-sparing surgery versus amputation depends on various factors, such as tumor size, location, and involvement of critical structures. A multidisciplinary approach is necessary to determine the optimal surgical approach for each individual patient, taking into account the tumor characteristics, the patient`s overall health and functional goals, and the expertise of the surgical team. This review article highlights the current treatment modalities for extremity soft tissue sarcomas, including surgery, radiation therapy, and systemic therapy.