Before performing a musculoskeletal biopsy, we are obliged to carefully analyze the clinical, laboratory and imaging elements of our patients. Once this information has been obtained and analyzed, we must generate a presumptive diagnosis that allows us to adequately plan the biopsy. For this purpose, we must consider the probable treatment and its surgical approach; based on this, choose the corresponding access route for biopsy. The type of biopsy depends on the clinical picture, the presumed diagnosis and the experience of the members of the multidisciplinary team related to each case.