The development of osteoporosis and fractures in young premenopausal women is infrequent and is usually associated with secondary causes of osteoporosis. Therefore, it is recommendable to perform a clinical evaluation and a thorough laboratory study searching for possible causes of bone loss in these patients. Treatment depends on the cause of osteoporosis and the associated processes as well as the future gestational desire of the patient, all of which should be taken into account when evaluating the most adequate diagnostic and the therapeutic approach in these patients.