Background: Musculoskeletal tumors pose significant diagnostic and treatment challenges. Accurate assessment of these tumors is critical for therapeutic decision-making, especially concerning limb salvage surgeries. Magnetic Resonance Imaging (MRI) offers detailed visualization, making it an invaluable tool in the evaluation of the extent and nature of such tumors.

Aims and Objectives: To assess the involvement patterns of bone, periosteal, and soft tissue in musculoskeletal tumors through MRI.

To correlate the findings of operable MRI cases with the results observed during intraoperative procedures.

Methods: After securing ethical committee clearance and informed consent, 60 patients with musculoskeletal tumors were referred to our department for an MRI study. Based on these MRI findings, plans for limb salvage surgeries were coordinated by both surgical oncology and orthopedics teams.

Results: Our cohort study's diagnostic accuracy, sensitivity, and specificity are detailed for each study variable. The mean age of participants was found to be 27.75 +/-14.97 years, with a notable male dominance (Male: Female ratio of 2.5:1). Separate sections elucidate the skeletal distribution, tumor nature, periosteal reactions, articular surface, soft tissue, neurovascular bundles, and intra-medullary involvements observed in our study. The sensitivity, specificity, and diagnostic accuracy of MRI stand at 97.6%, 94.4%, and 70% respectively.

Conclusion: This highlights MRI's pivotal role as the preferred modality in delineating the scope of musculoskeletal tumors, stressing its utility in ascertaining tumor invasion extents and its importance in preoperative evaluations and treatment assessments.