The chapter on pelvic and appendicular bone metastases reviews epidemiology and pathophysiology of bone metastases outside the spine and cranium. It discusses the role of various imaging modalities in particular strengths and weaknesses of radiographs, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine techniques. The diagnostic approach to bone lesions is laid out, and differential diagnoses are debated. The malignancies with the most common bone metastases, breast and prostate cancer, are discussed. The chapter debates treatment options and fracture risk assessment. It ends with a consideration of imaging follow-up during and after treatment.