In recent years Quantitative Ultrasound (QUS) approaches have increasingly been used for the assessment of osteoporosis. Extensive study results exist for the estimation of osteoporotic fracture risk. Also, results exist for the analysis of properties which characterize osteoporosis--low bone mass and deterioration of bone architecture. However, the existence of different methods, devices and parameters has to be taken into account. Moreover, the status of the evaluation is different for each type of device. Measures of quality assurance and in-depth knowledge about limitations of the approach are of substantial importance for clinical use. Because of the lack of ionising radiation and their lower cost, QUS approaches--if used appropriately--can play an important role in the assessment of osteoporotic fracture risk.