The aim of this study is to evaluate the effect of submaximal aerobic exercise with and without external loading on bone metabolism and balance in postmenopausal women with osteoporosis (OP). Thirty-six volunteer, sedentary postmenopausal women with OP were randomly divided into three groups: aerobic, weighted vest, and control. Exercise for the aerobic group consisted of 18 sessions of submaximal treadmill walking, 30 min daily, 3 times a week. The exercise program for the weighted-vest group was identical to that of the aerobic group except that the subjects wore a weighted vest (4-8 % of body weight). Body composition, bone biomarkers, bone-specific alkaline phosphatase (BALP) and N-terminal telopeptide of type 1 collagen (NTX), and balance (near tandem stand, NTS, and star-excursion, SE) were measured before and after the 6-week exercise program. Fat decreased (p = 0.01) and fat-free mass increased (p = 0.005) significantly in the weighted-vest group. BALP increased and NTX decreased significantly in both exercise groups (p ≤ 0.05). After 6 weeks of exercise, NTS score increased in the exercise groups and decreased in the control group (aerobic: +49.68 %, weighted vest: +104.66 %, and control: -28.96 %). SE values for all directions increased significantly in the weighted-vest group. Results showed that the two exercise programs stimulate bone synthesis and decrease bone resorption in postmenopausal women with OP, but that exercise while wearing a weighted vest is better for improving balance.