Patients with rheumatoid arthritis are at high risk for osteoporosis and fracture. Their risk factors for developing osteoporosis or fracture include two major categories: general risk factors including age, gender, family history of osteoporosis, low body mass index, fall risk, and poor lifestyle; and disease-related risk factors including inflammatory activity, activity limitation, and glucocorticoid application. For patients with rheumatoid arthritis, there are three aspects of preventing and treating osteoporosis. 1, Adequate immunosuppressive therapy prevents both local and systemic bone loss; therefore, ideal treatment of the disease is the first step in preventing fractures. 2, A healthy lifestyle is also important to consume adequate calcium, ensure vitamin D levels, prevent falls, and prevent activity limitation. 3, For patients with low BMD T values, bisphosphonates can be used. Calcium and vitamin D supplementation is also beneficial for patients with rheumatoid arthritis who are at risk of osteoporosis due to glucocorticoid use. In conclusion, patients with rheumatoid arthritis are at high risk for osteoporosis and fracture, and the main mechanisms of bone loss are bone destruction and systemic bone loss due to inflammation, and local bone loss due to activity limitation. Calcium deficiency is prevalent in RA patients and is an important risk factor for the development of osteoporosis in RA patients. Calcium and vitamin D supplementation can significantly improve bone mineral density and prevent glucocorticoid-induced osteoporosis in RA patients, and is a basic measure for the prevention and treatment of osteoporosis in RA patients recommended by domestic and international guidelines.