ObjectiveOsteosarcoma (OS), the most common malignant bone tumor, is prone to early metastasis and recurrence, resulting in poor prognosis. The purpose of this study was to investigate gene expression in OS samples, and to study the relationship between tumor infiltrating immune cells (TIICS) in the tumor microenvironment and the occurrence, development, and prognosis of OS. MethodsIntegrated analysis was performed on the gene expression profile of OS samples in the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database, and normal muscle tissue samples in the Genotype-Tissue Expression (GTEx) database. Screening of differentially expressed genes in OS samples and healthy muscle tissue samples was performed using R software. Functional annotation and pathway enrichment analyses were performed, a protein-protein interaction network was constructed, and the Hub genes were screened. The infiltration differences of 22 TIICs in OS samples and normal muscle tissue samples were analyzed using CIBERSORT. ROC curve, and OS survival analyses were performed on the Hub genes and 22 TIICs. The correlation between Hub genes with prognostic value and the 22 TIICs was discussed. ResultsTen Hub genes were screened. OS and normal muscle tissue samples were compared. Significant differences were observed in the infiltration of follicular helper T cells, resting NK cells, plasma cells, activated CD4 memory T cells, gamma delta T cells, monocytes, M0 macrophages and resting dendritic cells (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for the 10 hub genes was 0.9 ~ 1.0, and for naive B cells (AUC=0.942), plasma cells (AUC=0.999), follicular T helper cells (AUC=0.814), resting NK cells (AUC=0.864), monocytes (AUC=0.987), and M0 macrophages (AUC=0.995). Kaplan-Meier curves revealed positive correlation between the expression levels of TNNI2, TTN, ACTN3, TNNC2, MYL3, and survival of OS patients. Correlation analysis revealed close association between ACTN3, TNNI2, TNNC2, MYL3, TTN, and the infiltration of M0 macrophages and plasma cells. ConclusionOur findings provide a theoretical basis for further study of the molecular mechanisms underlying OS development and occurrence. It serves as a reference for the development of new diagnostics, identification of prognostic biomarkers, and targeted drug therapy for OS.