This article provides an overview of the current burden of osteoporosis and its complications in today’s health care system. The impact of osteoporosis on patients’ quality of life and direct financial consequences to the entire health care system are emphasized to highlight the need for increased knowledge and awareness of its complications if left untreated or treated incorrectly. Special attention is given to hip fracture and vertebral compression fracture, stressing the importance of diagnosing osteoporosis before fragility fractures occur. Models for improved care of fragility fractures during follow-up in the outpatient setting and the use of pharmacologic agents are discussed.