Surgery for soft tissue sarcoma is complex and requires specific expertise. It involves the en bloc removal of the tumor along with surrounding healthy tissue to ensure microscopic negative margins, in order to maximize the chance of cure. However, the extent of surgery should be tailored to the type and subtype of the soft tissue sarcoma. Soft tissue sarcomas encompass over 70 histologic entities, each characterized by distinct behaviors, recurrence patterns, and responses to treatment. Various treatment modalities are available, including radiotherapy, chemotherapy with different agents, and isolated limb perfusion. The strategy should be personalized, considering the tumor type, size, location, sensitivity to treatments, and the patient’s preferences. When patients are referred after an initial unplanned resection and no macroscopic tumor remains, immediate re-excision versus delayed wider resection upon recurrence should be discussed. Regionalizing soft tissue sarcoma care significantly improves the overall outcome.