&NA;A variety of surgical techniques is available for treatment of metastatic disease of the spine. Prior emphasis on the use of these procedures has been on their benefit as a palliative measure to relieve signs and symptoms of spinal cord and nerve root compression not aided by radiation therapy and corticosteroid administration. More recently, development of surgical techniques that combine neural decompression with restoration of spinal stability has brought about consideration of additional indications for surgery in the treatment of metastatic disease of the spine. The present scope of such surgical procedures is reviewed along with identification of the most reliable selection factors for surgical candidates in order to improve functional outcome from surgical treatment of metastatic disease of the spine. Over 70 surgical series with more than 2,000 patients treated were reviewed. (Neurosurgery25:240‐252, 1989)