Osteosarcoma, Ewing sarcoma, and chondrosarcoma constitute the three most common primary bone sarcomas. The lungs are the most common site of metastatic spread from these malignancies, followed by the skeleton. Advancements in imaging technologies, as well as wider access to these modalities, have enabled earlier and more accurate detection of metastases from these malignancies. CT has largely superseded conventional radiography as the preferred modality for initial detection of lung metastases. For completion of staging, TC-99m MDP skeletal scintigraphy, FDG-PET/CT and whole-body MRI are commonly utilized in the evaluation of distant disease. Due to their respective strengths and weaknesses, these modalities may be used in a manner that is complementary to one another. This chapter provides an overview of the patterns and common imaging appearances of metastatic spread of primary bone tumors, and reviews how our approach to staging and evaluation of treatment response has changed over time.