The spine is one of the most common sites of metastasis from distant structures, following the lung and the liver. Aim: to review the pathological distribution, clinical presentation and different surgical procedures and outcome of cases with neoplastic spine lesions managed at our departments. Patients and methods: this is a review of 29 patients presented with destructive spine lesion with compromised neural structure at different degrees, with no history of trauma or infection. All patients subjected to full neurological examination and ASIA scoring, and full radiological evaluation. Different surgical approaches were utilized. Results: this a retrospective study of 29 patients, 11males and 18 females. Mean age of presentation was 50years old. The affected vertebral bodies are 47 distributed among vertebral regions: 6 sacral (12.8%), 16 lumbar (34%), 6 thoracolumbar (12.8%), 12 thoracic (25.5%), 3 cervicothoracic (6.4%), and 4 cervical (8.5%). As regard surgical procedures, 5 patients CT guided biopsy. One case operated by core biopsy and vertebroplasty. 4 patients were managed by posterior neural decompression and debunking. 12 patients operated posterior excision and reconstruction. 3cases approached by anterolateral thoracotomy. 2 cases operated posterior excisional biopsy and Craniocervical fixation. One case was managed by anterior transoral excision. One case approached through anterior cervical corpectomy. Conclusion: in selected cases surgical management of patients with spine neoplastic lesions followed by adjuvant therapy is considered to relieve pain, decompress neural structures, stabilization and correction of deformed spine, and local control with also improvement of quality of life but not the survival.