The concept of oligometastatic disease as an interim stage of malignancy between localized and widely systemic disease has altered the landscape of metastatic disease management from one of pure palliation to one of prolonging survival and possibly providing cure. However, distinguishing between a true de novo oligometastatic state versus a polymetastatic state that has not yet become clinically detectable is still difficult to determine. Decision for metastasectomy must be made in conjunction with the patient as well as in a multidisciplinary fashion, as many factors must be considered such as systemic treatment plan, and other treatments such as radiation or ablation therapies.