OBJECTIVES: Osteoporosis is an important public health issue due to its rising prevalence and excess morbidity and mortality among this population. The present study aimed to demonstrate the use of clinical data repository in Israel's second largest health organization (Maccabi Healthcare Services) to establish a registry of osteoporosis patients and assess its early findings with respect to the epidemiology and burden of the disease, high risk populations, and quality of care.  METHODS: Included in the registry are patients with history of osteoporosis diagnosis, typical fractures (e.g. closed fractures of proximal femur, vertebral, Colles' and proximal humerus) and or purchases of relevant medications, documented since 2000. In addition, we included patients with low bone density from over 140,000 measurements, using an automated Optical Character Recognition (OCR) system. Patients younger than 18 years of age, diagnosed with Paget’s disease or purchasing pamidronic or zoledrnic acid due to cancer were excluded. Registry entry date was defined as the first medical event consistent with any of inclusion and all exclusion criteria. RESULTS: We identified 118,141 patients with osteoporosis, with a point prevalence of 19% in 2013 among members aged 50+, and an average incidence of approximately 6,300 cases a year. Average age at registry entry was 61 y/o for women and 66 y/o for men. 66% of the patients had more than one qualifying criteria. 28% of the registry patients were never treated. CONCLUSIONS: The methods and results described may provide a model for the development of an important tool to assess the substantial burden of osteoporosis and to monitor the quality of care over time.