Thermal ablation of tumors is a rapidly growing field that has found various applications in the musculoskeletal system. Radiofrequency ablation (RFA) has become the reference standard for treatment of most osteoid osteomas. More recently, RFA has been applied to several other forms of primary tumors and in the treatment and palliation of osseous metastases. Cryoablation using new closed systems has also become available for the percutaneous treatment of both primary and metastatic lesions, and the initial results have been promising.