Osteoarticular mucormycosis is relentlessly progressive, with bone destruction that necessitates extremity amputation. This case reports a 16-year-old female with pre-B cell acute lymphoblastic leukemia (B-cell ALL) who underwent consolidative haploidentical hematopoietic stem cell transplantation (HSCT) and developed Zygomycetes spp. osteomyelitis after receiving anti-TNF therapy for presumed pulmonary GVHD. Due to progression on systemic therapy, she received the adjunct of intra-operatively placed amphotericin B cement beads changed at regular surgical debridement over 6 weeks. This case demonstrates that early diagnosis and aggressive anti-fungal therapy with surgical debridement and amphotericin cement beads can allow limb sparing and complete recovery.