With the rapid increase in the number of organs transplanted worldwide and the improved survival of transplant recipients, osteoporosis has emerged as a frequent complication of the transplantation process. In the past decade, the wider recognition of transplantation-related osteoporosis has led to a decrease in the risk of fracture for the individual patient. Nonetheless, fracture rates remain unacceptably high in transplant recipients. This presentation reviews the epidemiology of transplantation-related osteoporosis, the factors contributing to the pathogenesis of this complication, and the evaluation, prevention, and treatment options available for kidney, liver, lung, and heart transplant recipients.