Soft tissue sarcomas are highly diverse mesenchymal malignancies of muscle, peripheral nerves, and adipose or fibrous connective tissues. Sarcoma classification had been entirely based on resemblance to various tissue types. More recently, classifications have been revised to include molecular features and genetic profiles of sarcoma. While our treatment paradigms for soft tissue sarcomas were developed on, what we know now to be oversimplified, histologic classifications, the addition of specific karyotyping and biomarkers has not changed our overall approach to these tumors in the majority. The local therapy paradigms are still based on surgery and radiation for the vast majority of these tumors.