Background: Sarcomas are rare cancers that warrant expert pathologic diagnosis (dx) and multidisciplinary treatment (MDT). We analysed details of patients (pts) diagnosed with soft tissue sarcomas (STS) and bone sarcomas (BS) referred to our centre. Methods: This is a retrospective study of pts diagnosed with STS or BS referred to All India Institute of Medical Sciences, Delhi between January 2021 and December 2022. Histopathological discrepancies were noted as change of primary dx or differences in grading or sarcoma subtyping on pathology review. Surgical and/or medical deviations from standard practise were identified. SPSS 26.0 was used for statistical analysis. Results: 268 pts with median age of 35 years (range 8 months-85 years) and male predominance (n = 140, 52.2%) were included. 121 (45%) pts belonged to adolescent and young age (AYA) group. 163 (61%) pts came from urban/semi-urban background and from a median distance of 90 miles (range 6.2-1587). Median symptom duration prior to referral was 9 months (range 6 months-12 years). Based on biopsy or cytopathological evidence, referred pts included 186 (69.4%) with STS, 73 (27.2%) with BS, 7 with undifferentiated sarcoma (2.6%) and 2 with carcinoma (0.7%). The most common STS (n = 186) were leiomyosarcoma (14%), synovial sarcoma (12%) and liposarcoma (8.3%); BS (n = 73) included osteosarcoma (44%), Ewing sarcoma (44%), chondrosarcoma (9.5%). Molecular and/or germline mutation tests were performed only in 9 of 131 (6.8%) indicated cases before referral. Localized/locally advanced and metastatic stages were found in 94 (35.6%) and 116 (43.2%) resp; rest (21.2%) did not undergo staging work-up outside. Common primary sites were extremity (n = 127, 44.4%), abdomen (n = 71, 24.8%), thorax (n = 24, 8.3%). 125 (43.7%) and 91 (31.8%) pts had undergone surgery and chemotherapy resp outside. 1st line chemotherapy (n = 85) was anthracycline-based (n = 65, 76.4%), ifosfamide-based (n = 6, 7%), gemcitabine-docetaxel (n = 5, 5.8%). 2nd line (n = 29) was gemcitabine +/- docetaxel (n = 7, 24.1%), anthracycline (n = 6, 20.6%), ifosfamide-based (n = 6, 20.6%), pazopanib (n = 6, 20.6%). Pathologic discrepancies found in 87 (30.4%) pts included change of primary diagnosis in 44 (15%), sarcoma subtype variation in 35 (12.2%) and benign disorder misclassified as malignancy in 5 (1.7%) pts. Deviations in chemotherapy (n = 43, 47.2%) included inadequate dose/cycles in 18 (42%), no chemotherapy despite indication in 8 (18.6%), non-standard regimens in 10 (23%) pts. Distance/rural residence did not correlate with pathology/treatment deviations. Conclusions: In this era of precision medicine and targeted oncology, our findings reflect the need for well-equipped diagnostic and treatment facilities. The lack of expert centres catering to pts with sarcomas remains a challenge in developing countries.