Glucocorticoid therapy is the most common cause of secondary osteoporosis and the leading iatrogenic cause of the disease. Often, the presenting manifestation is fracture, which occurs in 30% to 50% of patients receiving long-term glucocorticoid therapy. Glucocorticoid-induced osteoporosis predominantly affects regions of the skeleton that have abundant cancellous bone such as lumbar spine and proximal femur. Progress has been made in clarifying the pathophysiological mechanisms that result in glucocorticoid-induced osteoporosis. Although the options for prevention and treatment of glucocorticoid-induced osteoporosis continue to expand, provider compliance with preventive measures remains suboptimal.