Fractures represent the most important consequence of osteoporosis, as well as the major determinant of the socio-economic costs of the disease. Distal forearm, vertebrae and proximal femur fractures are frequently associated with the disease. Colles' fractures generally occur in women, showing a progressive increase in incidence after the onset of menopause, and reaching a plateau at the age of 65 years. Vertebral fractures are often painless and fortuitously diagnosed so that there are not many epidemiological data available. However, incidence rates appear to increase steadily with aging in women, while accelerating only in later life in men. In the elderly population, spine deformities due to vertebral fractures can contribute to the worsening of concurrent diseases. Fractures of the proximal femur represent the gold standard for epidemiological studies on osteoporosis. Their incidence increases exponentially in women 70 years old and over, and in men aged 80 or older. Moreover, that, femoral fractures are associated with a substantial risk of nonself sufficiency and mortality. Osteoporosis-related costs vary greatly among countries, not only because of a different incidence of the disease, but also due to the different emphasis on prevention, hospitalization, and treatment. The current dramatic increase of the elderly population exhorts against the postponing of a global strategy for preventing and treating the disease.