OBJECTIVES: To examine if bisphosphonate (BP) use is associated with drug related osteonecrosis (osteonecrosis) using adverse drug reaction (ADR) data reported in the Korea Adverse Event Reporting System (KAERS) from 2013 to 2015. METHODS: The KAERS database contained a total of 754,231 ADR reports from 38,974 patients, resulting in an average of 1.99reportsperpatient; the ADR reports include patient demographics, concomitant drugs, patients’ outcomes, reaction severity, reporting centers, and the results of causality assessments. The reporting odds ratio (ROR) was calculated to estimate the association between osteonecrosis and implicated medications. Chi-square tests were also conducted to compare the sociodemographic characteristics of osteonecrosis patients who reported BP use to those using other drugs. RESULTS: CONCLUSIONS: The risk of BP use for drug related osteonecrosis in ADR reports in South Korea were examined. The results imply that BP use needs to be carefully monitored for patients with susceptibility for osteonecrosis.