OBJECTIVES: Male osteoporosis is a common but neglected public health problem. This may be a result of limited data evaluating the efficacy of bisphosphonates for fracture prevention in males. This systematic review and meta-analysis study assessed the efficacy of bisphosphonates versus placebo in preventing fractures among males. METHODS: We searched PubMed/MEDLINE, Embase, Cochrane Clinical Trials Library, Clinicaltrials.gov, and Scopus. All randomized placebo-controlled trials of alendronate, ibandronate, risedronate, or zoledronic acid with reporting fracture outcomes were assessed. The trials had to include males, be at least one year’s duration, and utilize the United States. Food and Drug Administration approved bisphosphonate dosing. The outcomes of interest included clinical vertebral, morphometric vertebral, non-vertebral, hip, and any fracture. Fixed-effect models were used in both primary and subgroup meta-analyses. Publication bias was examined using funnel plots and Egger’s test. Meta-regressions were conducted to examine age, body mass index, bone mineral density T-scores, and proportion of male participants on the treatment effect. A sensitivity analysis using random effects assumption was also conducted. RESULTS: =0.0%; Male population: I=11.9%-15.3%). A visual inspection of the funnel plots and the Egger’s tests (Total population: p=0.119; Male population: p=0.690) indicated no evidence of publication bias. Moreover, meta-regression showed effect size was unrelated to male proportion. There was no significant superior treatment effect on other fracture outcomes. CONCLUSIONS: Bisphosphonates significantly reduced vertebral fracture, and the effect was consistent regardless of male proportions. This supports use of bisphosphonates in males at risk for fracture.