Osteoporosis is a devastating disease that is increasing in prevalence as our population ages. Prevention of osteoporosis is important to decrease osteoporosis-related fractures. Primary care practitioners are in the ideal position to actively screen women for osteoporosis and counsel them on risk reduction. This paper reviews population-based strategies for osteoporosis prevention and identification of high-risk women in a primary care practice. Practical methods of incorporating osteoporosis prevention counseling into a busy practice are presented.