Osteoporosis is an increasingly prevalent disease among the aging population, and osteoporotic features account for substantial morbidity, mortality, and healthcare costs associated with this disease. Because the disease is silent until a fracture occurs, the orthopaedic surgeon often may be the physician in the best position to establish the diagnosis and consider the initiation of appropriate treatment. Historically, osteoporosis has been underdiagnosed and treated, but new methods allow accurate diagnosis using bone densitometry, and a range of effective treatment options that can reduce fracture risk. Diagnosis and treatment of osteoporosis fits readily into an efficient algorithmic approach in the office practice of orthopaedics. Orthopaedic surgeons can play a major role in improving the treatment of osteoporosis and decreasing morbidity from this disease. In addition, this can augment the office practice of orthopaedics with a large yet relatively underserved patient population. Finally, densitometry services can provide modest supplemental revenue sources for an orthopaedic practice.