Spindle cell liposarcoma is highly malignant. Spindle cell liposarcoma generally belongs to pleomorphic liposarcoma. Liposarcoma is classified into highly differentiated liposarcoma, mucinous liposarcoma, dedifferentiated liposarcoma, and pleomorphic liposarcoma according to the different differentiation degree. Pleomorphic liposarcoma is the more serious type, which is less differentiated and more malignant, with the possibility of blood metastasis at an early stage, and the disease generally progresses more rapidly and is prone to recurrence. Surgery is the first choice for treatment, and localized wide resection is an effective measure to reduce recurrence and metastasis. After surgery, patients should actively cooperate with doctors in radiotherapy, chemotherapy and other treatments to avoid tumor recurrence to the greatest extent. If the tumor recurs or metastasis occurs after surgery, the only option is to undergo surgery again. Patients should maintain a positive attitude and cooperate with doctors to prolong the survival period and improve the quality of life.