Background: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. It represents 2.5% of childhood cancers. Survival has been completely changed thanks to early diagnosis and modern treatment combining chemotherapy and surgery, resulting in survival rates of over 70%. However, a paucity of studies on the pattern of its occurrence in LMIC such as Morocco. The objective of this study is to analyze the epidemiological, clinical, histological and therapeutic profile in Moroccan children with osteosarcoma. Methods: We retrospectively studied 91 patients of osteosarcoma collected from 2013 to 2016 at the four pediatric oncology units in Morocco which treat bone tumors (CHU of Fez, Casablanca, Rabat, Marrakech). Results: Osteosarcoma accounted for 3% of all patients treated for cancer during this period. All patients are histologically proven osteosarcoma. The male/female ratio was 0.85 with a mean age at diagnosis of 13 years. Swelling and pain were the main symptom. The most frequent location of involvement was the knee. Among the 91 patients, 40 patients didn’t have metastasis, while 40 had metastasis (pulmonary, bone). For 11 patients, they didn’t be evaluated for distant spread of cancer. The treatment options were chemotherapy and surgery. The evolution was marked by 31% of deaths, 36% of abandonment , 9% of lost to follow-up, while only 20% of complete remission and 4% alive under palliative treatment and. The 3-year survival study was 50%. Conclusion: The alarming data obtained prompt a review of the management process for patients in all stage of care pathways.