External hemipelvectomy ‘hindquarter amputation’ is a major surgical procedure whereby the hemipelvis at the level of sacro-iliac joint and symphysis pubis is removed together with the limb. It is indicated where oncological margin cannot be achieved with preservation of a viable limb. Pelvic or proximal femur sarcomas that requires hemipelvectomy usually present late, have a poor response to chemotherapy or are recurrent after primary internal hemipelvectomy. Critical structures for functions preservation in pelvic resections are the hip joint, femoral neurovascular structures and sciatic nerve. If more than two are involved, an external hemipelvectomy is justified. The decision to perform a hemipelvectomy is made when partial pelvic resection does not allow for safe surgical margin or results in a functionless limb. Even though hemipelvectomy has devastating results, it provides the possibility of surgical cure or palliation for pelvic malignancies that could otherwise not be excised with preservation of the limb.