Abstract: With the rapid development of omics and big data technology, there have been multiple achievements with the use of precision medicine for cancer treatment. Osteosarcoma, the most common primary malignant tumor of the skeletal system, primarily occurs in children and adolescents. Since the 1970s, surgical resection and chemotherapy have been the main treatments for osteosarcoma; however, the survival rate for this type of cancer has been stagnant due to high genetic heterogeneity. Precision medicine can provide a precise diagnosis and tailored treatments based on the patients' biological characteristics using techniques such as omics. Therefore, application of precision medicine is promising for studying osteosarcoma and improving patient survival rates. This study aims to systematically review the progress of precision medicine in advancing osteosarcoma treatment. In addition, it discusses the prospects and future direction of osteosarcoma precision treatment.