Oncologic orthopedic surgery stands as one of the primary causes necessitating blood transfusions. In an endeavor to mitigate transfusion requirements, the implementation of patient blood management (PBM) holds significant value. We undertook a retrospective study to juxtapose pre and post-PBM implementation scenarios in the context of treating osteosarcoma through limb salvage surgery in patients' extremities. This study encompasses 25 patients who underwent surgery between 2008 and 2016 at our institution, with a comparison drawn between cases before and after PBM adoption. Parameters such as transfusion rate (TR), transfusion volume (TV), and complications were subjected to analysis for both strategies. The PBM group exhibited notably reduced TR and TV compared to the control group (P < .01). PBM-associated complications primarily included anemia, reduction in hematocrit levels, and limited declines in hemodynamic status, which were generally mild and well-tolerated. In the control group, surgical site infections were observed in 13.3% of patients. When contrasted with the control group, the implementation of PBM in surgical interventions for osteosarcoma limb salvage procedures demonstrates its effectiveness in significantly reducing blood TRs.