Bracing for adolescent scoliosis has been postulated to cause permanent loss of bone mass and to predispose to adult osteoporosis. To determine whether brace use affects the rate of bone accretion with growth, the authors conducted a prospective study of 52 girls with adolescent idiopathic scoliosis. Dual-energy x-ray absorptiometry (DEXA) showed a significant increase in spinal bone mineral density (BMD) over a 1-year period of brace wear. BMD correlated with measures of growth and pubertal status, but not average daily brace wear or severity of scoliosis. The annual rate of bone density accumulation was similar to reported normal values. The annual rate of change of volumetric bone density increased only slightly during the study period, suggesting that most of the change in BMD with time reflects growth in the dimensions of the spine. Brace treatment does not appear to inhibit bone density accumulation in girls with adolescent idiopathic scoliosis.