In Japan, the prevalence of vertebral fractures, which increases with age, is about 10% in persons in their 60s and 35% in persons in their 70s. Vertebral fracture is considered a fragility fracture, which can be caused even by minor trauma. Diagnosis tends to be difficult with plain x-ray films, and computed tomography and magnetic resonance are likely to be helpful. Prognoses are particularly poor in cases with low bone density, cases with fractures at the transition from thoracic to lumbar vertebrae, cases with injury to the posterior walls, and cases in which treatment is delayed. The most important issue is fracture prevention by appropriately treating osteoporosis. When fracture does occur, it must be diagnosed early and treated effectively.