A review of the total number of cases of osteosarcoma referred to the Tumour Centre at the Rizzoli Orthopaedic Institute between 1904 and 1986, revealed 11 cases of the disease localised in the vertebrae, 9 of which were fully documented. We excluded secondary forms of the disease due to irradiation or malignant degeneration in Paget's disease, also metastases from osteosarcoma of the limbs localised in the sacrum. It is extremely important to distinguish osteosarcoma from osteoblastoma; and this problem is even more highlighted by the statistical evidence that both neoplasms have an almost equal probability of being localised in the spine. Treatment has progressed from the initial purely palliative approach to a more aggressive type of surgery which, in association with modern chemotherapy, makes it a more reliable type of treatment from the oncological point of view. To this aim, we emphasize the importance of performing biopsy according to the required criteria.