Named after its histologic resemblance to normal synovium, synovial sarcoma is a high-grade, malignant soft-tissue tumor that frequently occurs in the para-articular regions of the large joints of the extremities. Although it is often found in close association with tendon sheaths, bursae, and joint capsules, rarely does it involve the joint. Three distinct histologic subtypes have been described: biphasic, monophasic, and poorly differentiated. Synovial sarcoma accounts for approximately 8% of all soft-tissue sarcomas, and is most prevalent in adolescents and young adults 15 to 35 years of age. Wide surgical resection and adjuvant radiation therapy are the mainstays of treatment. Chemotherapy is also gaining a significant role. Five-year overall survival rates range from 36% to 76%. Tumor size greater than 5 cm, local invasion, metastases, and positive surgical margins have been shown to be negative prognostic factors.