The study examined the risk of mortality following clinical fractures in 6459 women aged 55–81 years participating in the Fracture Intervention Trial (FIT). Women with fractures were older, had lower bone mineral density, and were more likely to have a history of fractures. A total of 122 women died during the study, with 23 deaths occurring after a clinical fracture. The age-adjusted relative risk of dying after a clinical fracture was 2.15 (1.36, 3.42), primarily due to higher mortality after hip fractures (6.68, 3.08, 14.52) and clinical vertebral fractures (8.64, 4.45, 16.74). Mortality risk was not increased after forearm or other fractures. The study concluded that clinical vertebral and hip fractures are associated with a significant increase in mortality among relatively healthy older women. The study extended previous analyses of mortality following morphometric vertebral fractures and examined the risk of mortality following clinical fractures in women enrolled in the FIT, a randomized trial to assess the effect of alendronate on fracture risk. The study found that clinical vertebral fractures and hip fractures significantly increase mortality risk, while other fractures do not. The study population included women with low bone mineral density, and clinical fractures were defined as those that came to medical attention. Fractures were categorized into six types, and women were classified based on their fracture history. All deaths were confirmed by death certificates, and follow-up was complete. The study used proportional hazards models to estimate relative risks, adjusting for age, treatment, and other factors. The results highlight the importance of clinical vertebral and hip fractures in increasing mortality risk in older women.The study examined the risk of mortality following clinical fractures in 6459 women aged 55–81 years participating in the Fracture Intervention Trial (FIT). Women with fractures were older, had lower bone mineral density, and were more likely to have a history of fractures. A total of 122 women died during the study, with 23 deaths occurring after a clinical fracture. The age-adjusted relative risk of dying after a clinical fracture was 2.15 (1.36, 3.42), primarily due to higher mortality after hip fractures (6.68, 3.08, 14.52) and clinical vertebral fractures (8.64, 4.45, 16.74). Mortality risk was not increased after forearm or other fractures. The study concluded that clinical vertebral and hip fractures are associated with a significant increase in mortality among relatively healthy older women. The study extended previous analyses of mortality following morphometric vertebral fractures and examined the risk of mortality following clinical fractures in women enrolled in the FIT, a randomized trial to assess the effect of alendronate on fracture risk. The study found that clinical vertebral fractures and hip fractures significantly increase mortality risk, while other fractures do not. The study population included women with low bone mineral density, and clinical fractures were defined as those that came to medical attention. Fractures were categorized into six types, and women were classified based on their fracture history. All deaths were confirmed by death certificates, and follow-up was complete. The study used proportional hazards models to estimate relative risks, adjusting for age, treatment, and other factors. The results highlight the importance of clinical vertebral and hip fractures in increasing mortality risk in older women.