Development and maintenance of skeletal health is essential since the resultant effect of poor bone health is an increased risk of osteoporotic fracture. Osteoporosis is currently a major public health problem and with predicted demographic changes, its future health and economic impact is likely to be phenomenal. Adult bone health is predominantly governed by two factors: (i) Maximum attainment of peak bone mass; and (ii) rate of bone loss which occurs with ageing. Both aspects are determined by a combination of endogenous and exogenous factors and, although genetic influences are believed to account for up to three-quarters of the variation in bone mass, there is still room for the modifiable factors (including nutrition) to play an important role. This article covers clinical evidences of the positive effect of vitamin K2 on osteoporosis. The activity of vitamin K2 involves both an increase in the bone-building process and decrease in the bone-loss process. Article covers effect of vitamin K2 on bone homeostasis and its safety in children, hepatic and renal impairment. Vitamin K2 should be considered for prevention and treatment in those conditions known to contribute to osteoporosis.