Osteoporosis (OP) is a systemic metabolic lesion of the skeleton involving a reduced osseous tissue weight and an impaired microarchitectonics, which worsens the bone strength and contributes to a higher risk of bone fractures. An essential spread of OP and of osteoporotic fractures among populations in various countries, including Russia, a high-severity outcome, and big economic expenses related with treatment and rehabilitation are indicative of a high social OP significance. OP is a multi-factor pathology provoked by impaired processes in osseous remodeling with a higher resorption of osseous tissue and a reduced osteogenesis. A study of molecular mechanisms of intercellular interaction in OP resulted in discovering new elements in the family of tumor necrosis factor (TNF) and their ligands and receptors (RANKL-RANK-OPG), which are of primary importance in osteoclastogenesis and which are molecular mediators in many regulatory effects. The key drugs applicable to prevention and treatment of OP are also described in the article. The current methods of OP prevention and treatment improve the bone quality and reduce the incidence rate of fracture in an essential share of patients.