Osteoporosis treatments have become more complex with the introduction of 1st and 2nd line osteoanabolic treatment options and the need for consolidation or transitional therapies. This presentation will review the basic pathophysiology of osteoporosis, how anti-resorptive and osteoanabolic agents work and how to calculate absolute fracture risk using risk estimation in order to stratify patients to lifestyle treatment, antiresorptive treatment or osteoanabolic therapy.