Magnetic resonance (MR) imaging is the current radiologic method of choice for both detecting recurrent musculoskeletal neoplasm after surgical resection and defining its anatomic extent within soft tissue and bone. Various factors (such as the presence of surgical hardware and postsurgical seromas, hematomas, edema, scarring, and anatomic distortion) complicate the interpretation of postoperative MR imaging in these patients. By optimizing the MR imaging protocol, integrating relevant clinical and pathologic information (such as the date and extent of the most recent surgery and the histologic type and grade of the original tumor) during interpretation of the images, and being familiar with the typical manifestations of postsurgical changes and recurrent musculoskeletal tumors, the radiologist can maximize his ability to help guide patient management effectively.