A lot of work has been done in recent years to further improve the limb preservation rate of limb malignant tumors in China and abroad. In the past, limb malignancy could not be preserved mainly due to the involvement of important structures such as blood vessels, nerves, bones or extensive soft tissues. However, with the deeper understanding of the biological behavior of the malignant middle limb and the advancement of surgical techniques, the involvement of blood vessels can be reconstructed by autologous vessels or artificial vessel replacement; the involvement of nerves can be removed and inactivated by neural epithelium, and sometimes even the neurectomized residual limb can obtain better function than prosthesis by using orthopedic brace; the invasion of bones can be resected and reconstructed to obtain satisfactory margin. Bone invasion can be resected and reconstructed to obtain satisfactory margins, and in the case of extensive local soft tissue involvement, a free myocutaneous flap can be repaired and reconstructed to obtain satisfactory wound coverage. However, the more complex the surgery, the greater the potential for complications and the hope that limb preservation therapy will result in limb function at least superior to that of a prosthesis. In recent years, local treatment has gained more and more attention, such as particle implantation and post-mounted radiotherapy can be precisely placed around the neurovascular area where the tumor may remain without radiation damage to the skin; intraoperative radiotherapy can still achieve a 5-year local control rate of 57% for patients with positive margins; ultrasonic knife and microwave therapy can also achieve symptomatic relief in locally advanced inoperable limb malignancies; however, the most popular and most effective local treatment is regional thermophoresis. The former can result in limb-sparing resection of 85% of unresectable limb soft tissue sarcomas, while ILI can achieve tumor regression in 50% of locally progressive limb malignancies. In foreign countries, tumor necrosis factor has been applied since 1988 for regional thermophilic perfusion, and its combination with malfaram and interferon has become the main means of limb preservation for locally progressive limb malignancies, and in China, regional thermophilic perfusion has been applied since 1990s. We applied cisplatin and 67.6% of patients with tumor necrosis above grade III were treated with regional thermophilic infusion and were able to preserve their limbs. Especially for malignant black way metastasis, the efficiency of regional thermopharmacological perfusion is 100%, and the complications and toxic side effects can be controlled. Limb isolation irrigation is a kind of minimally invasive regional chemotherapy applied to localized advanced malignant tumors in the limbs. Its principle is similar to that of regional thermal drug infusion, both of which isolate the blood circulation of limbs from the body and locally administer drugs to achieve higher concentration and achieve the purpose of combined thermal effect of drugs against tumors through local warming. However, ILI drug action time is shorter (20min Vs 60min), temperature is lower than regional thermal drug perfusion (39℃ Vs 41℃), and residual blood and drug in the limb are discarded after irrigation, thus avoiding systemic toxicity. 2006 Memorial Sloan-Kettering Cancer Center (MSKCC) reported a phase II clinical trial of ILI in patients with locally advanced malignant black or soft tissue sarcomas of the limb, where the application of mafalan and actinomycin D for 20 min irrigation at no more than 39°C resulted in CR or PR in 50% of patients with mild toxicities. Phase III clinical studies on ILI combined with targeted therapy have been started at MSKCC, but there is no relevant application in China yet. Because of its easy operation and no need for complex equipment such as extracorporeal heart-lung machine, it is expected to be promoted in a large area.