Abstract: Objective: To analyze the outcome of malignant fibrous histiocytoma of bone (MFHb) and the effect of che -motherapy on limb-salvaging and local outcomes. Methods:Forty-two patients with a median age of 41 years (range, 11-69) who had high grade MFHb were retrospectively analyzed. The clinical, pathologic, and treatment variables were ana -lyzed for overall survival (OS) and distant-recurrence-free survival (DRFS). The impact of chemotherapy on limb-salvaging and prognosis were also analyzed. Results: With a median follow-up of 31months (range, 2-180 ), 18patients succumbed to their disease, giving a 2-year and 5-year OS rate of 79% and 45%, respectively. Twenty cases developed distant recur-rence, giving a 2-year and 5-year DRFS rate of 79% and 47%, respectively. In multivariate analysis, R2 resection and axial location were significantly associated with poor prognosis. Chemotherapy was effective in increasing the limb-salvage rate in patients with locally advanced disease. Conclusion: High grade MFHb has poor prognosis even when patients receive multimodal treatment. R 2 resection and axial location of tumor are independent prognostic factors associated with poor prognosis. Chemotherapy may play an important role in increasing the limb-salvage rate without sacrificing local control.