Managing a limb soft-tissue sarcoma with vascular and osseous involvement may necessitate innovative approaches. This chapter outlines the surgical management of a patient presenting with a soft-tissue lesion in the thigh, circumferentially surrounding the femur in the middle and lower third part of the thigh. There was encasement of the vessel with the presence of marrow lesions/metastases in the upper third of the femur. Surgical resection involved oncologically adequate excision of the soft-tissue sarcoma of the thigh with intercalary femur resection and vascular resection. Skeletal reconstruction was achieved with an antibiotic-impregnated cement spacer supplemented with stable internal fixation. This restored skeletal stability, permitted immediate weight-bearing ambulation, possibly reduced the incidence of postoperative infection and permitted postoperative radiation without fearing the deleterious effects of radiation on a biological reconstruction.