The authors set out to determine the distribution of bone quality, as measured by ultrasound, in a rural Nebraska population of women and men. Noninstitutionalized residents of Saunders County, Nebraska, who were age 50 years or older as of January 1, 1992, were enumerated. From this sampling frame, a randomized proportionate stratified sample was selected. The response rate to this random sampling was 58%. Bone quality was measured using the apparent velocity of ultrasound (AVU) through the patella. In addition to demographic information, participants were asked to describe all fractures that had occurred since age 40 years. Fractures were classified as resulting from low or high trauma. Like bone mass, previously studied extensively, AVU was lower among successively older strata for both sexes. AVU discriminated between those with and those without low-trauma or any fractures for both sexes, whether unadjusted or adjusted for nonresponse. AVU is a faster, cheaper, and less time-consuming procedure than bone mass. The measuring device is portable and is well suited for population-based studies. It remains to be determined, by prospective methods, whether AVU is a predictor of low-trauma or osteoporotic fracture in this population.