Family physicians will frequently encounter patients with osteoporosis, a condition that is oftenasymptomatic until a fracture occurs. Treatment of the fracture can be initiated without furtherdiagnostic testing. Thereafter, treatment of osteoporosis includes (1) prevention of further boneloss through weight-bearing exercise, tobacco and alcohol avoidance, hormone replacementtherapy in women, and raloxifene and calcium supplementation; (2) treatment of fracture-related pain with analgesics and calcitonin; (3) building bone mass when feasible with alen-dronate; and (4) modifying behaviors that increase the risk of falls. Patients without fracturewho are at risk for osteoporosis can also benefit from these preventive measures. Furthermore,women of all ages should be encouraged to maintain a daily calcium intake of 1,000 to 1,500 mgand to participate in weight-bearing exercise for 30 minutes three times weekly to reduce theirrisk of falls and fractures. Persons at risk should avoid medications known to compromise bonedensity, such as glucocorticoids, thyroid hormones and chronic heparin therapy. (Am Fam Physi-cian 2001;63:1121-8.)