Osteocalcin is a protein that is synthesized by osteoblasts, odontoblasts, and proliferating chondrocytes. It regulates bone metabolism and is a biochemical marker of bone metabolism, which is important in the diagnosis and treatment of osteoporosis and calcium metabolism diseases. If osteocalcin is pathologically elevated, it is mainly seen in diseases with accelerated bone turnover, such as primary hyperparathyroidism. Due to increased levels of parathyroid hormone, bone metabolism is significantly accelerated and bone decalcification occurs with a significant increase in osteocalcin. In addition, diseases such as menopausal syndrome, premature ovarian failure, and even PAGET bone disease, high-conversion osteoporosis, deformational osteitis, bone metastases, osteochondrosis, and traumatic bone injury can cause pathological osteocalcin elevation.