To prevent osteoporotic fractures, it is important to identify patients at high risk of fracture by assessing risk factors such as underlying diseases and drugs. Prior and current use of oral corticosteroids is strongly associated with increased fracture risk, but other medications could be involved and should be assessed as part of the optimal care of patients at risk of osteoporosis. Strong evidence points to gonadotropin-releasing hormone agonists, aromatase inhibitors, and antiepileptic drugs. Further studies are necessary to confirm the deleterious effect of other treatments on bone.