Abstract: The spine is the most common site of bone metastases. Massive pain, spinal cord compression and neurological dysfunction are common manifestations of spine metastases, negatively impacting the patients' quality of life. Previously, treatment options for spinal metastases, including radiotherapy and surgical treatment, were based primarily on prognostic scores such as Tomita or Tokuhashi. We now have a better understanding of which factors influence survival and quality of life after surgery, and several new techniques have been developed over the past decade to make surgery for spinal metastases safer and more acceptable to patients by decreasing postoperative pain and length of hospital stay. Especially, stereotactic body radiation therapy, minimally invasive techniques and targeted therapy have revolutionized the management of metastatic spine tumors.