Malignant bone tumors compose a small percentage of all malign tumors in the human body. They form miscellaneous clinic and biologic characteristics even though they are quite rare. Metastatic bone tumors are much more common than the primary bone malignancies. Only certain orthopedic centers and orthopedists have broad experience about malignant bone tumors. However orthopedic surgeons in non-oncologic practice should recognize the signs and symptoms suggesting malignant bone tumors, avoid delayed and improper treatment approaches, and refer the patient to an appropriate oncologic center. Malignant bone tumors have characteristic clinic, radiologic and laboratory features. The most important symptom is pain while resting or increased night pain. Swelling and decrease in range of motion is the most common clinical sign. There is no common clinical algorithm suitable for all bone malignancies. Many of the malignant bone tumors have their own specific radiologic signs. The best can be provided by multidisciplinary approach. Orthopedic surgeon is a vital member of the medical team composed by pathologist, radiologist, radiation oncologist, medical oncologist and vascular surgeon. Proper staging and a well-planned biopsy is imperative for the approach in patients with suggested malignant bone tumors.