One man out of 5 experiences an osteoporotic fracture in his remaining lifetime at 50 years. Many comorbidities are associated with osteoporosis and fracture risk in men, with numerous associated risk factors beyond a decrease in bone mineral density (BMD), and also taking into account the risk of falling. A prevalent fragility fracture, oral glucocorticoid therapy for at least 3 months, and androgen deprivation therapy for prostate cancer are the three most common situations of increased risk of osteoporosis in men. Bisphosphonates, denosumab and teriparatide increase BMD and change bone turnover markers in the same magnitude as in women. The first anti-fracture data in men were obtained with zoledronic acid and denosumab.