The doctor can have an important effect on fracture prevention and patient quality of life through appropriate screening, diagnosis and treatment of patients at risk of fracture. Fracture risk assessment should be the primary focus of patient evaluation, incorporating epidemiologically derived risk assessment tools with bone densitometry such as FRAX. A patient's risk stratification can then be followed by treatment with an increasingly broad range of effective bone-preserving therapies. While established therapies are available, new therapies are in development with increasing focus on anabolic agents to improve bone strength. The efficacy, safety, and tolerability of new bone-sparing agents, or combinations of agents, may further enhance the clinical armamentarium of osteoporosis