This chapter discusses pathology of bone tumors. Diagnosis of bone tumors depends on good clinic—radiological correlation and a pathologist should never attempt to make a diagnosis of a bone tumor without integrating clinical, radiological and histological appearances. Bone tumors can be divided into primary and secondary bone tumors. Primary bone tumors arise in a normal bone whereas secondary tumors affect a bone with pre-existent pathology or as metastatic spread from another site in the body. Histopathology studies using hematoxylin and eosin stains along with proper clinicoradiological correlation remain the cornerstone of accurate diagnosis of bone tumors. Technical advances in surgical pathology like immunohistochemistry and molecular diagnostics have helped in improving the sensitivity and specificity of tissue diagnosis in difficult cases and in the evaluation of metastatic tumors.