Advances in the detection and treatment of many cancers have led to prolonged life and improved quality of life for patients with localized and metastatic cancer; however, the improved survival of patients with osseous lesions, coupled with the destructive nature of metastatic disease and the medications to treat these lesions, has increased the likelihood of vertebral body collapse. Conventional surgical techniques are often poorly tolerated by this patient population, whereas nonoperative management can lead to continued pain and diminished function in the terminal years of life. Vertebroplasty and kyphoplasty are minimally invasive vertebral augmentation techniques used to treat pain in such patients while maintaining a positive safety profile. Vertebroplasty and kyphoplasty are tools in a spectrum of treatments for vertebral compression fractures secondary to osteoporosis and metastatic disease and are not mutually exclusive. Additional research in this area in large cohorts of patients is needed to establish these techniques as safe and clinically cost-effective methods of treating patients with vertebral compression fractures secondary to spinal metastases.