Soft tissue sarcomas are rare diseases that encompass a very heterogeneous group of tumors with diverse pathology and clinically overlapping characteristics. Although some treatment options may be used across different subtypes, each is characterized by specific features and may benefit more from specific approaches. In such a rare and peculiar group of diseases, it is rather important to define the best strategy to prolong survival and improve the quality of life of the patients. Although anthracycline-based chemotherapy remains a milestone in the first-line setting, in recent years novel targeted and immune therapies have been developed and more tailored strategies are possible. For these reasons, every case should be discussed in a multidisciplinary board that includes all specialists involved in the treatment of these patients, since the combination of systemic and local treatments can often be proposed. In this short review, we present the state of the art and offer future perspectives for the management of soft tissue sarcomas.