OBJECTIVES: Due to high cost and limited availability of dual-energy x-ray absorptiometry (DXA), 77 percent of high risk population remains undiagnosed and therefore untreated for osteoporosis. To cope up with current scenario, pre-screening tools have become apparent as pragmatic tool for extensive screening of osteoporosis. Use of such tools would help health care professionals to make better use of bone densitometry and to cut billions of dollars cost associated with DXA. This study attempts to evaluate possible reasons that pose hindrance in implementation of such tools despite of reliability and cost effective nature of such tools. METHODS: Using convenience sampling method, a pre-validated questionnaire was used to conduct a cross-sectional survey among health care professionals in Malaysia. 5 endocrinologists, 10 orthopedic specialists, 25 medical officers, 30 hospital pharmacists participated from Hospital Pulau Penang while 33 community pharmacists and 27 general practitioners from Penang participated in survey(total 130). RESULTS: There was no statistically significant difference regarding knowledge of pre-screening tools among health care professionals belonging to different specialties. Although, 77% of participants have heard about pre-screening tools but only 53 % were able to identify the purpose of such tools. Out of list of 8 pre-screening tools, majority 36 % identified SCORE followed by MOST (22 %) as pre-screening tools while other tools were not identified. Only 5 % of participants have used such tools while 94 % showed willingness to use such tools and to encourage patients to undergo screening by such tools. Majority 61 % preferred leaflets/ brochures to gain information regarding availability and utility of such tools while least 13 % preferred continuous education programs. CONCLUSIONS: Proper awareness regarding availability and utility of such tools would not only help to improve patient’s quality of life also it would help to reduce global economic burden associated with osteoporosis.