Sarcomas of the head, neck, trunk and breast are biologically similar to and behave like the soft tissue tumors found in other anatomic areas. In the past and still today, radical surgical resection with negative margins is the only reliable treatment for these sarcomas. The opportunity to use chemotherapy, surgery, and radiation therapy in selected patients as a multimodality approach may improve the likelihood of long-term, disease-free survival. Added experience with radiologic evaluation of patients to accurately define the anatomic location of the tumor, more definitive pathology to assess the biologic aggressiveness of the lesion, and more conservative wide excisions have allowed patients to retain function and cosmesis. In addition, the development of new surgical techniques has made it feasible to reconstruct large surgical defects.