Osteoporotic fractures (especially of the hip and vertebrae) can cause serious complications and sequelae, so it is important to effectively prevent and treat osteoporosis and related fractures in clinical practice. The guidelines developed by the Chinese Medical Association’s Osteoporosis and Bone Mineral Diseases Branch state that primary prevention of osteoporosis is aimed at preventing the development of osteoporosis and avoiding fractures in people who do not have fractures but have risk factors for osteoporosis or have reduced bone mineral density. Secondary prevention and treatment is aimed at patients with existing osteoporosis or fractures, with the aim of preventing them from developing fractures. The prevention and treatment of osteoporosis is described as a “pyramid” model. The first step of prevention and treatment is the basic measures, namely lifestyle interventions, including adequate calcium and vitamin D intake, appropriate physical activity and fall prevention; the second step is the search and treatment of secondary factors causing osteoporosis; and the third step is pharmacological interventions to improve bone density and reduce the risk of fracture. The current drugs for the prevention and treatment of osteoporosis are mainly divided into bone resorption inhibitors, bone formation promoters and drugs with multiple effects, with a course of treatment of at least 1 year. Clinically used are estrogens (one of the main means to prevent osteoporosis in postmenopausal women, clinicians must strictly grasp the indications and contraindications, low doses and short-term applications are appropriate), selective estrogen receptor modulators, calcitonin (has a significant reduction in bone pain, especially for patients with compression thoracolumbar fractures), bisphosphonates (currently the first-line international drugs to prevent osteoporosis), parathyroid hormone and strontium salt (a new anti-osteoporosis drug, which inhibits bone resorption while promoting bone formation, thereby enhancing bone density and significantly reducing the risk of fracture).