Purpose: This study aimed to evaluate the health status and quality of life in patients with osteosarcoma of the proximal fibula following surgical treatment. The procedure necessarily involved resection of the peroneal nerve, resulting in iatrogenic footdrop. Methods: From January 2005 to 26 August 2020 patients with osteosarcoma in the proximal fibula were treated at the oncology department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Clinical-pathological features as well as outcomes of these patients were investigated. Meanwhile, to clarify their health status, the SF-36 health survey questionnaire was administered at 12, 24, and 36 months post-diagnosis. Results: The outcomes for patients with osteosarcoma in the proximal fibula were encouraging. Both the three-year disease-free survival rate and the overall survival rate were recorded at 88.5% (23/26). Data from the SF-36 health survey questionnaire, completed by 20 patients who underwent limb-sparing surgery, revealed that at 24 months, patients perceived themselves as less healthy, both physically and emotionally, compared to their status at 12 months. Despite observing significant recovery at 36 months, the health status did not return to the levels reported at 12 months. The majority of patients (n = 17) identified "footdrop after surgery" as the primary factor affecting their quality of life. Conclusions: Osteosarcomas affecting the proximal fibula typically demonstrate a favorable prognosis following multi-modal treatment. However, patients' health status, including psychological well-being, requires improvement. Oncologists should strive to achieve an "equilibrium point" that minimizes the risk of recurrence while preserving peroneal nerve function.