Cell–cell communication plays a crucial role in bone development and maintenance, in health and disease. Our knowledge of the signalling pathways that regulate the communication of osteoblasts, osteoclasts and osteocytes is improving with time, giving us a better understanding of the regulation of the bone remodelling process. Bone cell communication has wider significance than the local tissue environment, however, with bone derived factors playing a role in whole-body homeostasis, including energy metabolism and kidney function. Similarly, there are a range of systemic conditions which affect the maintenance of bone mass. Understanding these complex interactions, the autocrine, paracrine and endocrine signalling involved in the regulation of bone health is paramount to a better understanding of bone disease, and ultimately developing targets for pharmaceutical intervention.