Osteoporosis, a disease which occurs more frequently in women, is characterized by low bone mass and micro-architectural deterioration of bone tissue and is the most common chronic metabolic bone disease. Annually contributing to 8.9 million fractures worldwide. Osteoporosis is associated with considerable morbidity and mortality. The prevalence of osteoporosis increases with age, and in parallel, there is an elevation in the rate of incident fragility fractures. This article explores the origins of bone and examines the physiological mechanisms involved in bone homeostasis relevant to the management and treatment of osteoporosis.