Aim and Objectives: The aim of this study was to evaluate the management and outcomes of patients with synovial sarcoma in the extremities. Material and Methods: 46 patients were included in this retrospective longitudinal study conducted at a tertiary cancer center between 2010 and 2017. There were 29 males with a median age of 21 (7-70) years and 17 females with a median age of 35 (13-50) years. On immune-histochemical staining CD-99 and vimentin stained positive in 100%, and BCL2 Positive in 94 %. Results: Limb salvage with wide excision was performed in 28 (61%) and amputation was needed in 18(39 %).12 (26%) received neoadjuvant chemotherapy with ifosfamide and Adriamycin-based chemotherapy. Older Age (>25 years) was associated with lower 5- yeardisease-free survival (p=0.04). The high-grade tumor was associated with lower 5-year disease-free survival (p=0.008). The 5-year disease-free survival in tumor size ≤ 10 cm compared to tumor size >10 cm had no significant difference. The median disease-free survival in the neoadjuvant chemotherapy group as compared to no neoadjuvant chemotherapy was (28.5 vs 21 months) (p>0.05). The adjuvant treatment group and nonadjuvant treatment group had median disease-free survival of 29 months and 11.5 months respectively. Conclusion: The age of the patient, stage of the tumor, tumor differentiation, and metastatic disease at presentation are risk factors for poor survival for patients with synovial sarcoma. The patients treated with adjuvant radiotherapy or adjuvant chemoradiation had beneficial outcomes as compared to patients who received no adjuvant treatment.