The multimodal treatment of soft tissue sarcomas (STS) is subject to constant change and further development. The chapter “Surgical Treatment and Innovations in Soft Tissue Sarcoma Care” is intended to give the reader a basic insight into the various treatment algorithms for STS. After a brief overview into the epidemiology, histology as well as pathophysiology of STS, the basic treatment algorithms are discussed. The various preoperative preparatory measures are presented followed by the actual surgical resection. Here, emphasis is placed on the importance of resection margins. In addition, new treatment measures such as preventive lymphovenous anastomosis and the possibilities of plastic-reconstructive surgery are presented. Finally, postoperative measures with a special focus on adjuvant therapy options are discussed. There is also an outlook on current research fields in adult STS as well as possible clinical implementation of experimental therapeutic approaches. The treatment of STS remains an exciting and challenging field within the treatment of malignant diseases. After studying this chapter, the reader will have a comprehensive overview of the treatment of STS, with a specific focus on the role of resection margins.