Abstract: Bone metastasis, as a common terminal event in patients with advanced malignant tumors, significantly impacts patients' quality of life and survival prognosis, posing a major clinical challenge in the field of oncology. With the deepening understanding of tumor biology, the treatment paradigm for bone metastasis has progressively shifted from traditional palliative care to precise targeted interventions. Currently, clinical treatment strategies have demonstrated diversified development, with various therapeutic approaches-including radiotherapy, immunotherapy, bone-modifying agents, and small-molecule targeted drugs—achieving notable clinical progress. However, existing treatment regimens still face challenges such as significant interindividual variability in efficacy, frequent drug resistance, and prominent adverse effects. This article systematically reviews the latest advances in precision therapy for bone metastasis, provides an in-depth analysis of the strengths and limitations of different treatment strategies, and offers perspectives on future research directions and therapeutic prospects, aiming to provide reference for optimizing clinical practice and promoting translational research.