Limb-salvage surgery plays a major role in the management of patients with osteosarcoma. As prognosis improves, reconstructive options have come under greater scrutiny with regard to their durability and functionality. The advent of computer navigation-guided reconstruction is discussed in detail, along with methods by which resections can be performed more conservatively, thus facilitating less radical reconstruction. The known modalities of reconstruction, namely biological, nonbiological and composite, are described with reference to the most recent literature. We also discuss changes that have been introduced in order to reduce known complication risks, such as infection, in patients with osteosarcoma. Areas requiring further consideration are highlighted.