Osteoporosis currently affects up to one in three women and one in 12 men. In 1990, there were 1.6 million hip fractures per annum worldwide and this number is estimated to reach 6 million by 2050. This increase in the number of fractures is due to an increase in the number of elderly people in the population, improved survival, and an increase in the age-specific fracture rates of unknown etiology. The rising number of osteoporotic fractures and their associated morbidity will place a heavy burden on future health care resources. In the United States, the cost for the management of osteoporosis has been estimated at $17 billion. The majority of this cost is spent on the acute surgical and medical management following hip fracture, and the subsequent rehabilitation. Currently, only minimal costs are utilized for treatment and prevention of osteoporosis. Hopefully, however, an accurate assessment of the burden of osteoporosis on the individual and the health care system will enable the targeting of resources to tackle this growing problem. With an increasing number of effective pharmaceutical interventions, it is critical that these agents are targeted to those at greatest risk for future fracture. This will ultimately reduce the burden of osteoporosis in future years.