Six cases of osteosarcoma occurring between 1971 and 1992 and involving the axial bones were reviewed. They constituted 4% of 129 osteosarcomas occurring in the skeleton in childhood during the same period at our center. The patients' ages ranged from eight to seventeen years. Four of the six patients were female. The distribution of axial bones of osteosarcoma was as follows: one case was in the vertebrae, two cases in the craniofacial bones (maxilla and mandible), two cases in the pelvis and one case in the ribs. The prognosis was very poor, with only one case of mandible osteosarcoma still alive. The other five patients died three to sixteen months after diagnosis. A combination of wide surgical resection and aggressive chemotherapy may offer the best chance for longterm survival.