The histologic and clinical characteristics of 54 patients with osteosarcoma are reviewed. The association of rapid linear bone growth with the occurrence of this tumor is confirmed, and evidence for increased growth in these adolescent patients is presented. A significant increase in female survival is seen in this study, and the literature relevant to gender and survival is reviewed. A histologic characterization of six predominant tumor patterns is presented with correlation to survival. Increased survival is seen with two specific histologic patterns, but there is great variability in the histology and sampling of osteosarcomas, and the series is small.