This report examines the evidence on the effectiveness of various strategies for diagnosing and monitoring postmenopausal women with osteoporosis. Specifically, it addresses: (1) the role of risk factors in identifying high-risk women and guiding their initial treatment, (2) the advantages and disadvantages of various techniques for bone measurement in predicting risk of hip or spine fracture, (3) the effectiveness of bone measurement tests for monitoring response to treatment and for guiding treatment change, (4) the role of markers of bone turnover in diagnosis and treatment management, (5) the evaluation of patients with osteoporosis for secondary causes, and (6) the costs and cost-effectiveness of various diagnostic strategies for osteoporosis.