Fifty-eight children between age 6 and 18 years were treated for osteogenic sarcoma in the period 1962 to 1987. Fifty-one patients with no preoperative pulmonary metastases (group A) had an overall 5-year survival rate (T5) of 41%; they were subdivided into three subgroups. In subgroup A1 treated with surgery and/or radiotherapy (15 cases), the 5-year survival rate (T5) was 33.3%, as in the classical historical series. In subgroup A2 treated with surgery and postoperative chemotherapy (19 cases) the T5 was 38.8%. In subgroup A3 treated by surgery and pre- and postoperative chemotherapy (17 cases) the T5 was 66.6%, which was statistically the best therapy (p < 0.5). This confirms the general trend in orthopedic oncology. Further data proved the negative prognostic value of male sex, while the grade of tumor and the surgical margins were important factors, but not statistically significant. Seven patients with preoperative metastases (group B) had a T5 of 0%.