The forearm comprises unique anatomical structures and is one of the few locations in the body where most muscles run in close vicinity to one another and almost in parallel. Soft tissue sarcomas of the forearm are rare tumours needing special consideration, as their location involves complex anatomy and limited tissue volume. The goal of forearm STS treatment is to perform limb-sparing surgery with wide resection margins, while preserving the function of the distal upper extremity. Surgical margins should never be sacrificed in an attempt to maintain hand function. Wide resection for sarcoma can entail large, deep and complex defects as well as functional deficits. Careful planning is mandatory to achieve functional reconstruction. Immediate reconstruction using free-tissue transfer has advantages of minimising fibrosis and early rehabilitation. Furthermore, motorised functional transfer will improve the functional deficit following resection.