Osteosarcoma is a malignant tumor of the bone, commonly found in adolescents and young adults, primarily occurring near the proximal tibia, distal femur, and proximal humerus, mostly at the metaphyseal ends. The tumor itself can lead to bone destruction and periosteal reactions. Pathological fractures may occur, which are frequently observed clinically. If a fracture occurs, radiographic examination can generally detect it, often showing a Codman's triangle or sunburst pattern. Early detection and treatment are crucial. Once a pathological fracture is observed, it typically indicates a middle to late stage of the disease, with a particularly high likelihood of lung metastasis. The situation with just a pathological fracture is quite severe, and unlike other fractures that might be managed with steel plates or intramedullary pins, treatment here is conservative, possibly requiring amputation, though limb-sparing approaches may also be necessary. Detecting the condition early, before distant metastasis, and combining treatment with radiotherapy or chemotherapy, can result in a five-year survival rate above 50%. The threat posed by pathological fractures alone is significant, and amputation may be necessary, with chemotherapy likely required post-surgery.