Spinal metastases are observed in 39% of all cancer patients. Spinal metastases cause a decrease in quality of life via intolerable pain and neurological deterioration. The optimal treatment modality usually depends on the expected survey, functional score, neurological deficit, existence of a spinal deformity and the amount of the compression fracture. Open surgeries are associated with high mortality and morbidity rates in these patients who have increased comorbidity. Percutaneous methods have lower risks and may be utilized for diagnostic and treatment purposes. Combination of percutaneous biopsy methods with radiological imaging allows an increased accuracy of the histopathological diagnosis. Different approaches may be adopted for each spine region. Percutaneous vertebroplasty and kyphoplasty allows obtaining biopsy, relieving pain that is caused by the compression fracture and maintaining spinal stability via increasing the vertebral body height. Percutaneous radiofrequency ablation provides local tumor control for patients in whom other treatment methods have a high risk. This technique causes protein coagulation, irreversible cellular damage, and a consequent tissue necrosis inside the tumor. Better pain control and improvement in quality of life may be achieved when vertebroplasty and tumor ablation are combined. Percutaneous instrumentation may be used for patients with instability and deformity, as a less comorbid alternative to open surgeries. It has been shown that percutaneous stabilization has less postoperative wound healing problems and infection when compared to open instrumentation techniques. In this review, we summarized the percutaneous techniques for diagnosis and treatment of spinal metastases and discussed the advantages and disadvantages of each method.