ABSTRACT: Osteoporosis has a fivefold greater prevalence in women than in men. In the United States, although women only have twice the fracture rate of men, they sustain 80% of hip fractures because older women far outnumber older men. In 2005, the cost for direct care of the estimated 2 million osteoporosis-related fractures was projected to be $17 billion, with hip fractures accounting for approximately 72% of the cost 1. Morbidity and loss of function can occur with all fractures and consequently present a significant burden to the patient, the family, and society. Morbidity and mortality are especially high with hip fractures. Of women older than 80 years who have had a hip fracture, only 56% could walk independently after 1 year 2. Approximately 3–6% of women die of complications while hospitalized for hip fracture, an outcome often correlated with comorbidity and age 2 3. Many aspects of gynecology and obstetrics can affect bone health. Obstetrician–gynecologists have the opportunity to play a key role in the prevention of osteoporosis and osteoporotic fractures. The purpose of this practice bulletin is to review the diagnosis, evaluation, and treatment of osteoporosis.