The surgical management of benign PNSTs and some other benign tumors can result in successful outcomes. Schwannomas and nonplexiform neurofibromas can be resected with minimal deficit by sparing all but the fascicles entering and exiting the tumor. These fascicles, if not functional by NAP testing, can be resected, and the tumor can be removed. Surgery to remove other benign lesions, such as intraneural ganglion cysts, hemangiomas,and ganglioneuromas, has become more timely. The desmoid tumor, although microscopically benign, is locally and regionally invasive, and chemotherapy and radiation therapy may need to be used as adjunctive therapy. Neurogenic sarcomas and other malignancies have high morbidity and mortality despite aggressive limb ablation or limb-sparing surgery with adjunctive therapy. Thus, surgery involving decompression as well as the most complete resection possible remains the essential initial step in the management of most malignancies.