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Regional lymph node metastasis (RLNM) has been reported to be a prognostic factor for poor survival outcomes of bone sarcoma. However, studies about risk factors for RLNM of bone sarcoma are extremely rare, and the outcome of such patients remains to be explored. We aimed to identify risk factors for RLNM of bone sarcoma and conduct survival analysis for patients with bone sarcoma with RLNM. A total of 10,641 patients confirmed of malignant bone sarcomas from 1983 to 2014 were identified from the Surveillance, Epidemiology, and End Resu