Osteoporosis is a skeletal disorder characterised by low bone mass and an increased susceptibility to fracture. The last two decades have seen an increase in our understanding of the epidemiology of fractures at the three most frequent sites (the hip, wrist and vertebral body). These new insights have led to the delineation of preventive strategies against these fractures for both the general population, and those individuals at highest risk. This review covers these descrptive epidemiological characteristics, as well as approaches to prevention.