Background: Sarcopenia and osteoporosis are common age-related conditions that frequently coexist, forming a syndrome known as osteosarcopenia. Sarcopenia is defined by the progressive loss of muscle mass, strength, and function, while osteoporosis is characterized by reduced bone mineral density and altered bone quality. Together, they significantly increase the risk of falls, fractures, and functional decline in older adults. Summary: Osteosarcopenia arises from shared pathophysiological mechanisms, including chronic low-grade inflammation, oxidative stress, hormonal changes, and nutritional deficiencies. These factors contribute to a cycle of musculoskeletal deterioration. In addition to systemic pathways, local muscle-bone crosstalk mediated by myokines and osteokines plays a critical role. Management requires a comprehensive approach. Nutritional interventions such as adequate protein, calcium, and vitamin D intake, along with anti-inflammatory nutrients like omega-3 fatty acids and polyphenols, support musculoskeletal health. Resistance and weight-bearing exercises are essential to maintain muscle and bone mass. Pharmacological treatments for osteoporosis include bisphosphonates, denosumab, and anabolic agents, while investigational therapies for sarcopenia, such as selective androgen receptor modulators and myostatin inhibitors, offer potential benefits. Key Messages: Sarcopenia and osteoporosis share risk factors and often coexist in older adults. Early diagnosis and integrated treatment strategies are essential. Nutrition, exercise, and pharmacologic interventions can mitigate the burden of osteosarcopenia. A combined approach is more effective than treating each condition separately and may reduce falls and improve quality of life.