Soft-tissue sarcomas encompass a diverse group of rare neoplasms that can occur in any compartment of the body. They provide a therapeutic challenge to clinicians because of their typically large size at presentation, as well as their potentially close proximity to critical structures (ie, blood vessels, nerves). Even when a macroscopically complete resection with negative microscopic margins is achieved, local and distant recurrence rates are significant. Optimal management of patients with soft-tissue sarcomas should involve a multidisciplinary approach, with involvement of a surgical oncologist in addition to medical and radiation oncologists. Utilization of neoadjuvant therapies potentially provides local and distant control. The use of neoadjuvant therapy is influenced by the tumor biology (histologic subtype and grade), as well as the tumor location, and remains an area of controversy. The aim of this review is to discuss current neoadjuvant treatment options for soft-tissue sarcomas.