The incidence of bone tumors in the population is about 0.01%. Among bone tumors: benign accounts for 50%, malignant accounts for 40%, and tumor-like lesions account for about 10%. The incidence of primary bone tumors is low, about one-tenth of the incidence of other tumors. Primary malignant bone tumors, commonly known as “bone cancer”, account for 5% of malignant tumors in children, mostly occurring in adolescents aged 10-20 years old with vigorous growth and development, among which Ewing’s sarcoma has a younger age of onset than osteosarcoma, mostly occurring in 5-30 years old. Although the incidence of malignant bone tumor is not high, it has high malignancy, high mortality and disability rate, and occupies a very important position in orthopedic clinic, so parents should pay enough attention and alert. Due to the relatively slow course of malignant bone tumor, it is not easy to attract the attention of children and parents when it develops, so many children are diagnosed late and lose the opportunity of early treatment, and the prognosis is poor. For malignant bone tumors, like other tumors, early detection, early diagnosis and early treatment (i.e. “three early”) are the keys to successful treatment. Malignant bone tumors are mostly found in long tubular bones such as femur, tibia and humerus, with distal femur and proximal tibia, i.e. around knee joint, being the most common. Some children have pain at night and often wake up in their sleep. Although the incidence of this disease is much higher than that of bone tumors, we must be careful because the early manifestations of malignant bone tumors in the proximal tibia are sometimes similar to those of “growing pains”. The early manifestations of proximal tibial malignant bone tumor are sometimes similar to “growing pain”, which can be confused and delay treatment. As the disease progresses, the pain is progressively aggravated, the pain site is fixed, local swelling may appear gradually, the skin temperature is higher than the opposite side, some children may have fever, poor appetite, anemia and other symptoms. If these symptoms appear, it indicates that the disease is progressing rapidly, so it is time to consult a doctor as soon as possible to make a clear diagnosis. The diagnosis of malignant bone tumor is mainly based on clinical manifestations, X-ray examination and pathological examination, and the combination of these three factors can make a clear diagnosis. For the treatment of malignant bone tumor, the main progress in the past 20 years lies in the preoperative chemotherapy and limb preservation surgery and artificial tumor prosthesis implantation. Early effective and correct chemotherapy and complete surgical resection have greatly improved the survival rate and maximized the preservation of limb function, but due to the extremely malignant biological characteristics of the tumor itself, it determines the poor prognosis of malignant bone tumor and high rate of lung metastasis. Regular chemotherapy before and after surgery is still the only effective way to solve the problem. The etiology of malignant bone tumors is not clear, and there are various theories such as environmental, genetic and radiological, etc. A definite conclusion can still not be given, and likewise an effective set of preventive measures cannot be formulated. However, early detection and early diagnosis are equally important for the prognosis of this disease. Children in the peak of growth and development are the most likely candidates for this disease. Insensitivity to specific changes in a particular part of the body, lack of verbal expression, many daily activities, easy sprains and falls are also distinctive features of children in this age group. Therefore, parents should pay attention to closely observe the special changes of their children, and if the above-mentioned manifestations appear, they should go to the specialist’s clinic as soon as possible to make a clear judgment through professional examination.