Introduction Bone tumors are rare and account for about 6% of childhood cancer in with its incidence increasing with age until late adolescence. Despite various approaches in the treatment of bone tumors, the improvement in outcome has been minimal. This review summarizes the descriptive epidemiology of primary bone tumors in children and adolescents. In addition, it provides an overview of the most seen common tumor types, and most affected bones. Objectives To determine the epidemiology of primary bone tumors in children and adolescents (5 -19 years old) admitted at KCMC Orthopaedic department. Methodology A hospital based descriptive cross-sectional study was conducted at KCMC Orthopaedic department in which all patients within the age of 5 to 19 years diagnosed and/or treated for primary bone tumors from January 2006 to December 2015 were included in this study. Data was extracted from patients’ hospital files and analysed using SPSS version 20. Results The study included 80 patients with primary bone tumors who were admitted at KCMC Orthopedic department from the year 2006 to 2015, 15(18.8%) patients were aged 5 to 8 years while 81.3% were 9 to 19 years. Males comprised 58.8% of the study participants. The long bone of the lower extremity, femur (30%) held primacy over all other localizations. The knee joint and the hip joint were equally affected,12.5% each, followed by the humerus (7.5%), tibia(7.5%),digits(5%),scapula(4%), clavicle(3.8%),fibula and tibia(3.8%),ankle joint(2.5%),calcaneum(1.2%),femur & tibia(1.2%),talus(1.2%) and vertebrae column.The three most common primary bone tumor types histopathologically proven were Osteosarcoma (61.2%), chondrosarcoma (10%) and Exostosis (6.2%) , followed by osteochondroma (5%), then by giant cell tumor and cavernous hemangioma 3.8% each. Others were Chromyxoid fibroma, xi Enchondroma, Chondroblastoma, inclusion body fibromatosis, fibrous Histiocytoma, lipoma and bone cyst whereby each comprised 1.2% of the cases seen. Conclusion Osteosarcoma is the most common primary bone tumor seen in children and adolescents who were treated at KCMC Orthopaedic department, followed next by Chondrosarcoma and Exostosis. Long bones of the extremities are the most affected sites with the femur holding primacy over all other localisations. The vertebrae column is the least affected site. Men are more affected than females and adolescents (9 to 19 years) were more affected than children (5 to 8 years).