Desmoids are a unique subset of soft tissue tumors. While they can cause symptoms related to local progression, they do not metastasize and a subset have indolent behavior, in some cases regressing spontaneously. Because surgery for desmoids can be morbid and recurrence rates are high, non-operative treatment has become the preferred treatment strategy for desmoid patients. Active observation, regional therapies for anatomically appropriate cases and medical therapies can all be employed in patients with desmoid-type fibromatosis. Aimee M. Crago, MD, PhD, and Brian E. Kadera, MD, discuss cases requiring non-operative management to assist listeners in integrating recently published data into their practices.