This paper reviews briefly the development and clinical use of FRAX in the development of assessment guidelines for osteoporosis.Fractures are the clinical consequence of osteoporosis and are a major cause of morbidity and mortality worldwide. Several treatments are available that have been shown to decrease the risk of fracture, but problems arise in identifying individuals at high fracture risk so that treatments can be effectively targeted. Case finding can be enhanced by the consideration of clinical risk factors that provide information on fracture risk over and above that provided by bone mineral density measurements. The FRAX tool integrates information on fracture risk from clinical risk factors with or without the use of BMD and can be used to improve the targeting of individuals at high fracture risk.