OBJECTIVES: This study aims to investigate the major osteoporotic fractures incidence in Taiwan from 2006 to 2009. METHODS: Using the inpatient and outpatient database of the National Health Insurance. Elderly Women (50-100 years) who had primary and secondary diagnosis of hip fracture (ICD9 code 820, 733.14), vertebral fracture (ICD9 code 805, 806, 733.13), wrist fracture (ICD9 code 813, 733.12), and other fracture (ICD9 code 807, 808, 810, 811, 812, 821, 823, 733.10, 733.11, 733.15, 733.16, 733.19) were identified and included in the study. Frequencies and incidences of each fracture by age were estimated, and the 4-year incidence trend was further evaluated. RESULTS: A total of 65,118 hip fractures, the most serious osteoporosis outcome, occurred during the study period and the incidence is increasing by 3-6% per year. We found a high annual incidence rate of clinical vertebral fracture in 4 consecutive years in Taiwan. The average rate was 1.43%, 1.51%, 1.59%, and 1.63% respectively. In addition, Wrist fracture and other fracture all increased slightly. Each type of fractures showed a steady increase in the age-adjusted incidence. CONCLUSIONS: The age-specific incidence rates of hip fractures and vertebral fractures were higher with increasing age, especially after 60 years of age. Compared with other countries, Elderly Taiwanese women also have a high incidence rate of hip and vertebral fracture. Our results clearly demonstrated that the effect of osteoporosis and osteoporotic fracture in Taiwan. We should take more active public health strategies in the rapidly aging society.