Bone sarcomas arising in the upper extremity are uncommon. When they do occur in the upper extremity, the most common locations include the proximal humerus, scapula, and distal radius. Treatment of any location requires the appropriate knowledge of the various surgical techniques and reconstruction methods to offer the patient the best functional and oncological outcome. Surgically, the complex anatomy and finely interrelated structures of the upper extremity may limit some surgical options; nonetheless, limb-sparing techniques (despite sometimes narrow surgical margins) may provide both local tumor control and considerable functional advantages for these patients by reducing the surgical morbidity and loss of function. However, amputations still serve as a valuable and effective surgical option when limb-salvage is not feasible.