Metastatic bone disease (MBD) is pervasive among cancer patients, given that bone is one of the most common organs targeted by metastasis. As MBD progresses, patients are at a risk of developing numerous morbidities known as skeletal-related events (SREs), ranging from pathologic fractures to hypercalcemia of malignancy. Treatment options for MBD often include addressing or preventing these events and are highly dependent on the patient’s prognosis. Hence, objective survival estimates from prognostic modeling are crucial to help determine the most appropriate surgical or nonsurgical interventions to improve or maintain patient function and quality of life. For instance, MBD patients with a short life expectancy of <6 months may undergo less invasive procedures such as thermal ablation and percutaneous cementation, while those with longer life expectancies of >6 months may undergo more invasive yet more durable reconstructive strategies. Ultimately, the life expectancy of MBD patients is largely tied to their primary cancer diagnosis with myeloma, lymphoma, breast, and thyroid cancers being positive predictors of survival, while lung and prostate cancers are negative predictors of survival. Broadly, outcomes for MBD patients have improved over the last 30 years, particularly with median survival times increasing for patients with breast, prostate, lung, and renal primary cancers.