Skeletal metastases can cause severe pain and functional impairment, secondary to direct invasion or osteolysis. Direct palliation of these metastases can reduce the burden of pain. Surgical excision or radiotherapy has been used to target these tumors. In precarious locations, such as the sternum, surgery may lead to significant morbidity. Radiotherapy requires multiple visits, which may be difficult for the severely disabled. Minimally invasive, image-guided procedures are gaining wider acceptance in treating these lesions. Kyphoplasty has been used for vertebral column metastases. Osteoplasty of a metastasis to a flat, non-weight-bearing bone is rarely reported. The author reports the successful palliation of a sternal metastasis with kyphoplasty. Ultrasound imaging was used with fluoroscopy. Reproducibility, by other providers, is imperative with any emerging technique; this will facilitate wider patient access and device innovation. Hopefully, future multicenter trials will validate the efficacy and safety of this technique.