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Osteoporosis affects approximately 25 million Americans, the majority of whom are women. Every year older Americans experience more than 1.5 million osteoporosis-related fractures at a cost to the US health care system of more than $10 billion. As many as 32% of women and 17% of men up to the age of 90 will suffer at least one fracture of the hip, spine, wrist, or other susceptible bone attributable to osteoporosis. Up to 20% of victims of hip fractures will die within 1 year, and more than 50% of the survivors will be incapacitated. Osteoporosis is both preventable and treatable, yet it is often unrecognized and untreated. This article reviews current prevention and treatment approaches and presents relevant side effects and treatment precautions.