Bone tumors are divided into two categories: benign and malignant, but in daily life, it is often difficult for people to distinguish them. Sometimes, malignant bone tumors are treated as benign, which is not taken seriously and misses the good opportunity of treatment; or mistook benign as malignant, which causes great ideological pressure. Thus, it is very important to identify the benign and malignant tumors. So, what is the difference between them? The basic performance of benign and malignant bone tumor (1) The “benign” of benign bone tumor is more than the malignant one. From the clinical performance, benign bone tumor shows a lump first, no pain or light pain, slow growth rate and generally no systemic symptoms. The boundaries of the lump are clear, the surface of the lump is generally unchanged, there is no or slight pressure pain, no murmur on auscultation, and benign bone tumor has no tendency of systemic metastasis. (2) Malignant bone tumor, commonly known as “bone cancer”. From the viewpoint of clinical performance, malignant bone tumor is characterized by pain first, followed by lump, severe pain, obvious pain at night, rapid growth of lump, systemic symptoms sometimes including fever and emaciation, and even cachexia in advanced stage. The boundary of the mass is not clear, the surrounding tissue is infiltrated, its surface is red and hot, there is venous filling, pressure pain is obvious, murmur can be heard in rich blood circulation. Malignant bone tumor in advanced stage may have metastasis to other tissues and organs in the whole body. Patient’s main concern–treatment and prognosis From this aspect, benign bone tumors are mostly treated by local scraping and bone grafting or resection, and if they can be completely removed, they usually do not recur and have good prognosis. However, it should also be recognized that some benign bone tumors may recur or have the possibility of malignant change after treatment, therefore, sufficient attention should be paid to benign bone tumors. The results of auxiliary examinations are very important to distinguish benign and malignant tumors, among which imaging examination is the most valuable. There are still many difficulties in the treatment of malignant bone tumors, but with the development of medical technology and the adoption of comprehensive methods, the efficacy has been improved in recent years. Surgical resection is the main means of treatment. In addition to limb preservation, amputation and joint dissection are the most common methods. Chemotherapy is divided into systemic chemotherapy and local chemotherapy, in addition to immunotherapy and radiotherapy. However, the prognosis of malignant bone tumors is still poor and the mortality rate is high. In summary, there are many differences between benign and malignant bone tumors in various aspects. For benign bone tumors, patients need to pay enough attention to them because some of them may become malignant; while for patients with malignant bone tumors, they need to increase their confidence, actively cooperate and strive for better treatment results.