Osteoporosis and cardiovascular disease (CVD) are major public health problems, leading to increased morbidity and mortality. Although historically considered as independent conditions, clinical and epidemiological studies indicate that there are common pathophysiological mechanisms underlying these diseases. In addition to menopause and advanced age, risk factors for CVD, such as obesity and diabetes, have also been associated with osteoporosis. Dyslipidemia, oxidative stress, inflammation, hyperhomocystinemia are associated to bone remodeling impairment and to the atherosclerotic process and might explain, in part, the co-existence of osteoporosis and CVD.