Osteoporosis is a disabling disease, and despite the progress in treating this disease in recent years, it is still necessary to develop new treatment options. A potential target for new pharmacological agents with the ability to regulate bone metabolism is the purinergic receptors, also called P2 receptors. Nucleotides activate these receptors, and recent studies have shown a possible role for these in bone turnover and metabolism. P2 receptors can be further divided into P2X and P2Y subtypes, which have strikingly different mechanisms of action. They are expressed both by osteoblasts and by osteoclasts, and agonist binding affects cell proliferation, differentiation, activity and apoptosis. With increasing knowledge of the function and role of these receptors in bone biology, they will undoubtedly be a future target for the design of new drugs which can be used for treatment of metabolic bone diseases, including osteoporosis.