Although osteosarcoma and Ewing's sarcoma are quite rare, they are the only primary skeletal malignancies that occur with any regularity in children. The evaluation, diagnosis, and management of skeletal neoplasia are reviewed using these two diseases as the focus of discussion. Radiographic imaging, biopsy approaches, diagnostic considerations, and therapeutic management are explained. Demographics and pathophysiology of osteosarcoma and Ewing's sarcoma are explored in more depth.