The objective of this study was to determine the impact of glucocorticoid exposure on lumbar spine bone mineral density (BMD) in children while concurrently measuring their calcium intake, serum 25-OH vitamin D levels, and physical activity. Forty-three patients (4–18 years) with renal glomerular diseases, dermato-myositis, inflammatory bowel disease, juvenile rheumatoid arthritis, post—solid organ transplant, and Duchenne muscular dystrophy were studied. All received at least 5 mg per day of prednisone for more than 6 months. The mean BMD z score was 0 ± 0.2 (range, −3.8 to +3.3) with 2 patients (5%) having z scores less than −2. The mean daily calcium intake was 1147 ± 145 g, with 1 patient having hypovitaminosis D (<15 ng/mL). The mean physical activity level was 7.8 ± 0.8 h/wk. The small reductions in BMD observed in our population suggest that screening is likely not warranted in all children with chronic glucocorticoid exposure.