More than 70 years ago, osteoporosis associated with endogenous glucocorticoid excess was described by Harvey Cushing. More common is the increased fracture risk associated with exogenous glucocorticoids, a therapy used for many inflammatory disorders. Despite advances in biologically targeted therapeutics for these diseases, glucocorticoid-induced osteoporosis (GIOP) remains the most common secondary form of osteoporosis. For patients with postmenopausal osteoporosis, the fracture risk rises slowly over the years after menopause. In contrast, an increased risk for fracture can be demonstrated as early as 3 months after commencing therapy with oral glucocorticoids. © 2013 Elsevier Inc. All rights reserved.