Glucocorticoid-induced osteoporosis is one of the most important side-effects of glucocorticoid use, leading to an increased fracture risk. In this review, recent advances in the understanding of the mechanisms of glucocorticoid-induced osteoporosis are summarised. Methods to identify persons at risk for fractures are discussed, as well as the new ACR recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis (2010). Different treatment options are summarised considering the pathogenesis of glucocorticoid-induced osteoporosis. Improved insights into pathogenesis might result in development of new treatment possibilities.