Limb-sparing surgery has significantly improved functional outcomes for children with extremity soft tissue sarcomas. However, because tumors often involve critical structures such as nerves, bones, or arteries, surgery can still lead to lasting functional loss and persistent pain. Despite these challenges, little research has been published on the long-term functional status and pain in this patient group. This study aims to evaluate both functional outcomes and persisting pain after surgery for eSTS in children, providing valuable insights to optimize future treatment strategies.