Osteoporosis is a common problem encountered in primary care. Mortality and long-term morbidity is associated with almost all types of symptomatic osteoporotic fractures. Local data suggests that osteoporosis remains undiagnosed and undertreated. Primary care physicians play a central role in closing the gap for osteoporosis treatment with the opportunity to diagnose, investigate, and treat these patients effectively. In this article, we explore different pharmacological options in the treatment of osteoporosis, including the role of calcium and vitamin D, antiresorptive agents, hormonal therapy, and anabolic treatment options.