Osteoporosis consists of decreased bone density and is a silent disease until it is complicated by fractures resulting from minimal trauma or being atraumatic. Osteoporosis can be prevented, diagnosed and treated before fractures occur. The pharmacologic therapy for osteoporosis most commonly includes the use of antiresorptive agents such as bisphosphonates, denosumab and raloxifene. Anabolic agents that promote bone formation in patients at high risk of osteoporosis may also be used: the parathyroid hormone analogs teriparatide and abaloparatide. Romosozumab is a monoclonal antibody that stimulates bone formation, also acting as an antiresorptive. All anti-osteoporotic drugs should be administered with adequate calcium and vitamin D intake. Lifestyle modification is also indicated for good osteoporosis management.