The syndrome non-familial acro-osteolysis features bone reabsorption of the digits in association with short stature. Osteoporosis is common in this disorder, but no successful treatment has been previously reported. We report a case of non-familial acro-osteolysis complicated by multiple fractures in which treatment with antiresorptive therapy improved both biochemical markers of bone turnover and bone mineral density but had no effect on the acro-osteolysis.