The proper treatment of cartilaginous tumors is dependent on the clinicopathologic and radiologic findings. Enchondroma is a benign tumor that is usually asymptomatic and thus should be treated nonoperatively. Symptomatic enchondromas are often treated by intralesional excision. Intramedullary low-grade chondrosarcoma is a malignant tumor that is usually painful. The treatment of low-grade chondrosarcoma may range from intralesional excision with or without adjuvant therapy to wide excision. Although intralesional excisions have a higher bone and joint preservation rate than wide excisions, they may be associated with a higher local recurrence rate. Intermediate- and high-grade chondrosarcomas are treated with wide excisions. The treatment of these cartilaginous lesions should involve a multidisciplinary team including a musculoskeletal surgeon, a radiologist, and a pathologist.