Most patients with metastatic sarcoma will present with lung metastases. In most cancers, lung metastases connotes incurable disease. However, judicious aggressive management can achieve cure in a subset of sarcoma cases. I will present an evidence-based approach to management of sarcoma patients with lung metastases, and discuss some the key elements in optimal care. I will also discuss rare situations in which patients with benign giant cell tumor of bone may present with lung metastases, in which the outlook is very different.