The Clinician's Guide to Prevention and Treatment of Osteoporosis, developed by the National Osteoporosis Foundation (NOF) with input from medical experts, provides recommendations for the prevention, diagnosis, and treatment of osteoporosis in postmenopausal women and men aged 50 and older. Osteoporosis is a silent disease that can lead to fractures with minimal trauma or no trauma, causing significant medical and personal burden. It is preventable, diagnosable, and treatable before fractures occur, and effective treatments are available even after the first fracture. The guide emphasizes the importance of regular bone mineral density (BMD) testing, vertebral imaging, and risk assessment to determine the need for treatment. BMD testing is recommended for women aged 65 and older, men aged 70 and older, and for those with specific risk factors. Vertebral imaging is also recommended for individuals with certain BMD scores. The guide also highlights the importance of calcium and vitamin D intake, weight-bearing and muscle-strengthening exercise, and the avoidance of tobacco and excessive alcohol. Pharmacologic treatments, including bisphosphonates, calcitonin, estrogen agonist/antagonists, parathyroid hormone, and RANKL inhibitors, are recommended for patients with specific risk factors. The guide also discusses the use of the FRAX tool to estimate fracture risk and the importance of individualized treatment decisions based on patient-specific factors. The guide emphasizes the need for regular follow-up and monitoring of patients, including BMD testing and biochemical markers of bone turnover. It also highlights the importance of addressing secondary causes of osteoporosis and the role of lifestyle modifications in preventing and managing the disease. The guide concludes with recommendations for the use of FDA-approved drugs and the importance of patient education and compliance with treatment plans.The Clinician's Guide to Prevention and Treatment of Osteoporosis, developed by the National Osteoporosis Foundation (NOF) with input from medical experts, provides recommendations for the prevention, diagnosis, and treatment of osteoporosis in postmenopausal women and men aged 50 and older. Osteoporosis is a silent disease that can lead to fractures with minimal trauma or no trauma, causing significant medical and personal burden. It is preventable, diagnosable, and treatable before fractures occur, and effective treatments are available even after the first fracture. The guide emphasizes the importance of regular bone mineral density (BMD) testing, vertebral imaging, and risk assessment to determine the need for treatment. BMD testing is recommended for women aged 65 and older, men aged 70 and older, and for those with specific risk factors. Vertebral imaging is also recommended for individuals with certain BMD scores. The guide also highlights the importance of calcium and vitamin D intake, weight-bearing and muscle-strengthening exercise, and the avoidance of tobacco and excessive alcohol. Pharmacologic treatments, including bisphosphonates, calcitonin, estrogen agonist/antagonists, parathyroid hormone, and RANKL inhibitors, are recommended for patients with specific risk factors. The guide also discusses the use of the FRAX tool to estimate fracture risk and the importance of individualized treatment decisions based on patient-specific factors. The guide emphasizes the need for regular follow-up and monitoring of patients, including BMD testing and biochemical markers of bone turnover. It also highlights the importance of addressing secondary causes of osteoporosis and the role of lifestyle modifications in preventing and managing the disease. The guide concludes with recommendations for the use of FDA-approved drugs and the importance of patient education and compliance with treatment plans.