Advances in early detection and therapy of spinal metastasis have improved life expectancy of patients with various tumor entities. However, this and the demographic development have led to an increased risk for developing spinal metastases. Numerous prognostic factors have been determined to allow an assessment of outcome and survival time of patients with metastatic spinal tumors. The implementation of these factors into different scoring systems has been encouraging in the decision making process of spinal surgery. This overview highlights some of the most important prognostic factors and scores which may facilitate surgical considerations.