Osteoporosis is characterized by compromised bone strength that predisposes a person to an increased risk of fracture. It is a major public health problem that is often unrecognized in clinical practice. This paper provides an evidence-based approach for diagnosis, investigation, and treatment of osteoporosis. Identification and treatment of secondary causes of bone loss have also been discussed. Pharmacologic options include hormone replacement therapy, raloxifene, calcitonin, bisphosphonates, and parathyroid hormone. Nonpharmacologic therapies serve as useful adjuncts to medical treatment and include hip protectors, bracing, exercise, vertebroplasty, and kyphoplasty. This increasing range of treatment options allows better matching of therapy to patients. Copyright © 2003 by Current Science Inc.