OBJECTIVES: To examine the economic burden and health care utilizations of osteoporosis in the U.S. Medicare population.  METHODS: Osteoporosis patients were identified (International Classification of Disease, 9^th Revision, Clinical Modification [ICD-9-CM] code: 733.0x) from the U.S. national Medicare claims dataset from January 1, 2008 through December 31, 2010. The first osteoporosis diagnosis date was designated as the index date. One-year continuous enrollment was required for all patients pre- and post- index date. Charlson Comorbidity Index (CCI) scores and comorbid conditions in the 1-year baseline period were examined. Treatment patterns within 60 days post-index date, and health care utilization and costs for the follow-up period were analyzed descriptively.  RESULTS: A total of 141,833 patients (average age 78.1 years) were included in the study sample. Osteoporosis patients in the Medicare population were more likely to be female (88.9%), White (88.4%) and reside in the Southern U.S. region (38.7%). The average CCI score was 1.80. Comorbid conditions were common, including tumor (28.0%), diabetes (25.0%) and chronic obstructive pulmonary disease (23.8%). Osteoporosis patients had a high percentage of prescriptions for alendronate sodium (12.0%), levothyroxine sodium (10.9%) and simvastatin (9.0%) within 60 days post-index date.  Health care utilizations analysis showed the following results: Medicare carrier (99.4%), Durable Medical Equipment (DME, 36.9%), Home Health Agency (HHA, 18.5%), outpatient visits (81.6%) and inpatient hospital (29.6%), Skilled Nursing Facility (SNF, 12.3%) and hospice admissions (4.2%) and drug prescription drug claims (part D event) (56.3%). Health care costs for osteoporosis patients were determined as follows: Medicare carrier ($4,387), DME ($393), HHA ($1,126), outpatient ($10,836), inpatient ($5,728), SNF ($2,363), hospice ($445), pharmacy ($1,736) and total costs ($27,013).  CONCLUSIONS: Patients diagnosed with osteoporosis in the Medicare population have a high percentage of carrier and outpatient visits. The current study evidenced that high health care utilizations result in considerable expenditures.