Objective: To summarize the clinical features and prognosis of primary malignant fibrous histiocytoma of bone (PBMFH). Methods: The preoperative imaging data, diagnostic basis, treatment plan, and follow-up data of 24 PBMFH patients who were admitted to our hospital from October 2000 to January 2011 were retrospectively analyzed. Results: All the 24 patients were confirmed by postoperative pathology, the puncture accuracy rate was 75.00% . The results of chest X-ray showed that pulmonary metastasis was found in 2 cases, and none pulmonary metastasis was found in 22 cases. The results of local X-ray examination of tumor showed that: 3 cases presented osteolysis destruction, 1 case presented mass shadow, and 20 cases presented periodate reaction. The results of MRI examination showed that in 4 cases, MRI showed isointensity on T1WI and slightly hyperintensity on T2WI in 3 cases, and 1 case had low signal on T1WI and low signal on T2WI. In this study, metastasis occurred in 6 cases (33.33% ) of the 18 patients undergoing chemoradiotherapy, transfer time was 6 ~ 45 months, median transfer time was (25.30±6.24) months, 5 cases of the 6 patients in the surgical treatment group had metastasis (83.33%), transfer time was 3 ~ 6 months, median transfer time was (5.00±0.24) months. Conclusions: In PBMFH patients, metastasis occurred mostly at 35 months after surgery alone, and metastasis occurred mostly at 25 months after surgery combined with radical surgery and chemoradiotherapy. Thus it can be seen, preoperative biopsy pathology contributes to the diagnosis of the disease, and postoperative adjuvant chemotherapy helps to reduce the recurrence and metastasis rate of PBMFH. [ABSTRACT FROM AUTHOR]