Traditionally, osteoporosis has been predominantly studied in women; nevertheless, men are not protected from bone loss and its complications. Remarkably, mortality after osteoporotic fractures is higher in men compared to women. In men, both estrogens and androgens play an important role in the regulation of bone turnover. Pathophysiological specificities of osteoporosis in men are osteoblastic deficiency and a high frequency of secondary causes of osteoporosis. Several randomized control trials specifically investigated the treatment of osteoporosis in men and demonstrated a reduction of vertebral fracture incidence.