Malignant bone tumors seriously affect the quality of life of terminal patients and impose severe economic burdens on social health management owing to the complex pathogenesis, multiresistance, tumor recurrence, and metastasis, for which traditional clinical treatments are difficult to achieve the ideal therapeutic effects. Metal-based nanomaterials have shown great application potential in the treatment of malignant bone tumors because of their unique physicochemical properties, biological activities, and structural features, which have greatly improved their ability to kill malignant bone tumor cells and inhibit bone tumor growth by being designed as carriers, therapeutic agents, and coatings/scaffolds, combined with multimodal treatment methods, which have effectively overcome the problems of low efficacy, easy resistance, metastasis, and recurrence faced by traditional treatment methods. This paper summarizes the latest progress in malignant bone tumor treatment using metal-based nanomaterials through three modes of carriers, therapeutic agents, and coatings/scaffolds in recent years. In addition, the challenges and future development directions of metal-based nanomaterials in treating malignant bone tumors, such as improving biocompatibility, targeting ability, and therapeutic efficacy, were also investigated. Finally, the advantages and prospects of metal-based nanomaterials for the treatment of malignant bone tumors are summarized, providing a helpful reference for future research.