Osteosarcoma is a malignant tumor that is difficult to treat, has a high recurrence and mortality rate, and is generally treated with a combination of therapies. Currently, neoadjuvant chemotherapy is the standard treatment procedure for osteosarcoma, which includes three stages: preoperative chemotherapy, surgical resection, and postoperative chemotherapy. First, preoperative chemotherapy is given to patients in high doses to reduce the size of the tumor and the difficulty of surgery, which can reduce the recurrence rate and disability rate of surgery. The main chemotherapy drugs are methotrexate, cisplatin, adriamycin and isocyclophosphamide, and the choice of specific drugs is based on the patient’s basic condition and disease. Secondly, surgical treatment includes radical surgery and limb preservation surgery, according to the extent of tumor infiltration to remove the tumor segment and then implant a prosthesis. However, for those who have the condition to do extensive local excision in early stage, they should preserve the limb and do limb preservation surgery. Finally, chemotherapy is still needed after surgery to completely eliminate cancer cells in the body, reduce the recurrence rate and prolong the survival period. In addition, the incidence of lung metastasis of bone tumor is extremely high, so in addition to the above treatment, surgery can be performed to remove the metastases, and chemotherapy can be continued after surgery. The application of neoadjuvant chemotherapy has greatly improved the survival rate and limb preservation rate of patients with osteosarcoma. The specific treatment plan needs to be formulated by the bone oncologist according to the stage of the patient’s tumor.