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Osteoporotic fractures in men have been, until recently, a neglected health problem, but this area is now the subject of renewed interest and investigation. Osteoporosis, once thought, inappropriately, to be an inevitable consequence of aging, is now assuming increasing importance, especially in women, because of the morbidity and mortality associated with fractures, and the burgeoning public health burden that this represents. However, more recently it has also been recognized that men lose bone density with advancing age and are also subject to osteoporotic fractures. One in eight men older than the age of fifty years has an osteoporotic fracture, and some 30% of hip fractures, representing the greatest health care burden, occur in men. Moreover, the mortality rate after a hip fracture is greater in men than women. While osteoporosis in men and women have many similarities, there are some interesting differences. Present therapies, while not entirely empirical, have been guided by studies in women, and carefully controlled, randomized antifracture clinical trials in men are required.