The incidence of pathologic compression fractures continues to rise with the continued aging of the US population and improvements in survival of patients with oncologic disease. Accordingly, there is likely to be a commensurate increase in the number of patients with de novo kyphosis from these fractures. Management of pathologic fractures requires a multidisciplinary approach, including the patient’s oncologist, radiation oncologist, spine surgeon, diagnostic and interventional radiologist, and/or pain specialist. Treatment options for pathologic compression fractures resulting in kyphotic deformity include nonoperative management, radiation therapy, vertebroplasty/kyphoplasty, and surgical management. Indications for surgical intervention include progressive neurologic deficit, spinal instability, nonunion, and symptoms refractory to conservative treatment. However, this must be weighed against the risks of the patient undergoing a surgical procedure. If one is to proceed with surgical intervention, it is imperative to understand the patient’s global alignment as well as understand the nature of the kyphotic deformity, including curve magnitude, curve flexibility, and the length of the kyphotic segment. Both anterior and posterior procedures can be utilized to stabilize the spine and achieve deformity correction, and one may also utilize a variety of osteotomies depending on the amount of deformity correction desired.