BackgroundSoft tissue sarcomas (STS) are a rare group of malignant tumors originating from soft tissues. The study systematically evaluates the global burden of soft tissue and extraosseous sarcomas from 1990 to 2021 across diverse populations.MethodsWe examined incidence, mortality, and disability-adjusted life years (DALYs) using data from the Global Burden of Disease (GBD) 2021 database. Estimated annual percentage change (EAPC) assessed trends from 1990 to 2021. Cross-country inequality was evaluated using the socio-demographic index (SDI), inequality slope index, and concentration index. Decomposition analysis identified key drivers of changes in disease burden. Frontier analysis pinpointed countries with potential for improvement, while Bayesian age-period-cohort (BAPC) projected trends through 2036.ResultsAlthough the absolute numbers of cases, deaths, and DALYs increased, the global age-standardized incidence rate (ASIR), mortality (ASMR), and DALYs (ASDR) decreased. Males consistently exhibited higher rates than females, with the highest rates in individuals aged 95 and older. In high-SDI regions, ASIR slightly increased, whereas ASMR and ASDR decreased. The gap between high- and low-SDI countries widened over time. Projections indicate that by 2036, absolute numbers will increase, while age-standardized rates will further decline.ConclusionsDespite the increasing absolute burden, the global age-standardized rates have declined, likely reflecting multiple contributing factors. However, the persistent disparities underscore the need for improved access to care and targeted public health interventions to mitigate the global burden.