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Osteosarcoma is a malignant tumor, derived from primitive bone-forming mesenchymal cells, and its aggressive nature often leads to significant morbidity and mortality, with amputation being routinely performed in localized cases. Post-amputation morbidity has a significant impact on the quality of life of the affected individuals. The tumor frequently metastasizes to the lungs and bones, and widespread disease remains the leading cause of most patient deaths. Other metastatic sites are extremely rare. We report a rare case of a young boy who had developed osteosarcoma and was surgically treated, without any metastatic disease. Two years later, the patient developed an abdominal mass, which was diagnosed as metastatic osteosarcoma to the liver., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Imran et al.)