Osteoporosis and resulting fractures are very common medical issues seen in the rapidly growing older population. Adverse outcomes of osteoporosis complicated by fracture include increased mortality, functional decline, an increased requirement for long-term care services, decreased satisfaction with quality of life, and excess utilization of healthcare resources. Gynecologists frequently evaluate older women and should develop expertise in the prevention, diagnosis, and management of these common disorders. This chapter provides an overview of this important topic.