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Bone metastases are the most common cause of osteolytic lesions of bones in adults. Cancers most likely to metastasize to bone include breast, lung, kidney and prostate, while metastases are rare in colorectal cancer (although they cannot be dismissed). In this last case, metastases usually appear in advanced stages of the disease. Most of the metastatic lesions in women derive from breast cancer, and in the case of men, they derive from prostate cancer. Primary sarcomas of the bone do not usually metastasize to bone. Metastatic lesions are usually multiple, and they tend to appear on the axial skeleton and the proximal segments of the limbs. Their location, in decreasing order, is the following: dorso-lumbar spine, sacrum, pelvis, ribs, sternum, proximal third of the femur, proximal third of the humerus and cranium. Metastases affect the cancellous bone more, but they have a larger repercussion if they affect a cortical bone, because if load-bearing bones are involved, pathological fractures may appear. Colorectal carcinoma may generate metastasis on the cancellous and cortical bone. According to the statistics, three out of every four patients who die of cancer present a bone metastasis, and an estimated 90% of cancer patients die of metastasis. Therefore, this is one of the final causes of the high mortality rates associated to cancer, and there is a limited amount of therapeutic and clinical resources to deal with it. The most common locations for these metastases are: spinal column, pelvis, ribs and pectoral and pelvic girdles. Acral metastases are rare and for this reason they will be analyzed separately.