Extensive technological advancements in imaging scanners and material equipment lead to the more important role of percutaneous procedures on the musculoskeletal system, which became more precise, safer and more efficient during the past decade. The aim of percutaneous diagnostic procedures is to etiologically define skeletal or soft tissue lesions. The most important percutaneous diagnostic procedure is percutaneous bone or soft tissue biopsy by which we want to delineate the definitive diagnosis of disease. The purpose of recent therapeutic ablation techniques is to perform palliative or curative treatment of bone tumours and tumour-like lesions. Palliative treatment of bone metastases is the most frequently performed procedure. The origin of bone metastases is most often from carcinoma of prostate, lungs, kidneys and thyroid gland. The leading clinical symptom is excruciating pain, which highly affects the quality of life in this particularly vulnerable group of patients. An important complication is the occurrence of a pathological fracture that usually appears on vertebral bodies and long bones. Percutaneous ablation of benign tumours and tumour-like lesions are performed according to their clinical importance. Traditional treatment options are radiotherapy, operative treatment, and combined medicamentous therapy. Current percutaneous ablation methods used in management of tumour lesions of the musculoskeletal system offer an additional opportunity for a less invasive treatment accompanied by standard therapeutic options and present an important contribution to therapy.