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Gross examination of surgical pathology specimens is a foundational component of pathology training and remains essential for the accurate evaluation of resection specimens. Bone and soft tissue tumors represent a rare and diagnostically challenging group of neoplasms that often require specialized expertise and subspecialty training for proper classification. Although definitive diagnosis typically relies on the careful integration of clinical, radiologic, histologic, immunophenotypic, and molecular findings; gross (macroscopic) features can provide valuable early diagnostic clues regarding tumor type, surgical adequacy, and biologic behavior. Despite their diagnostic value, the gross features of bone and soft tissue tumors are often underappreciated, in part due to the relative rarity of these neoplasms. In this review, we highlight selected bone and soft tissue tumors to emphasize the practical importance of careful gross examination in the evaluation and diagnosis of musculoskeletal neoplasia.