Abstract: Objectives: To analyze the clinical characteristics, diagnosis and treatment of parosteal osteosarcoma. Method: All patients were treated by surgical procedure. The replacement of prostheses was conducted in 7 cases, and local resection (semi-cortical resection) with allograft or autograft in 2. The amputation was done in 1 case. Results: The cases were followed up for 4.6 to 29 years, with no recurrence in the group. In the 4 cases, breakage of prosthesis occurred in 3 cases and late infection in 1. The amputation was done in 3 of the 4 cases, with limb conservation by articular overhauling in 1. The successful limb-conservation rate was 60%. Metastases on bilateral lungs occurred in 2 cases and both the patients received the resection of pulmonary metastasis of tumor, with a disease-free physical status for 21 years and 11 months, respectively. Conclusion: The parosteal osteosarcoma is a low-grade sarcoma and wide excision is the prerequisite for curing the tumor. The individual mode of operation is the guarantee for conservation of the sick limbs'function as much as possible. The chemotherapy and surgical procedure for pulmonary metastasis can still attain a good prognosis.