Abstract:[Objective] To observe the outcomes of denosumab as neoadjuvant therapy in the surgical treatment of refractory giant celltumor of bone. [Methods] A retrospective study was conducted on 12 patients who received treatment for refractory giant cell tumor of bonein our department from September 2020 to September 2022. Denosumab injection was injected subcutaneously once a week for 4 weeks be-fore surgery, followed by surgical treatment, and clinical and imaging results were observed. [Results] All patients were successfully operat-ed, with no nerve, vascular injury and other serious complications. After treatment, the tumor tissue became fibrotic and toughened to grayishwhite with clear boundaries, and histological staining showed a small number of osteoclast-like multinucleated giant cells in the local area.Compared to those before medication, the VAS score [(4.5±0.6), (2.1±0.8), (0.8±0.6), (0.3±0.4), P＜0.001] decreased significantly, whereasthe SF-36 score [(50.8 ±3.3), (53.6±4.2), (65.4±5.0), (81.7±3.7), P＜0.001] increased significantly 3 months after operation, and at the timeof the last follow-up. In terms of imaging, compared with those before medication, the maximum CT diameter of the lesion significantly de-creased [(65.3±15.1) mm, (52.3±14.0) mm, P＜0.001], whereas the lesion edge CT value [(98.2±30.5) HU, (276.1±79.1) HU, P＜0.001] andthe focal CT value [(38.4±10.4) HU, (97.1±20.0) HU, P＜0.001] significantly increased after denosumab therapy. [Conclusion] Denosumabcan be used as a neoadjuvant therapy to achieve surgical degradation, promote the complete curettage of tumor lesions, and preserve the nor-mal bone structure to the maximum extent to meet the postoperative functional rehabilitation.