OBJECTIVES: The use of economic evaluation studies has been increasingly common, especially in the field of osteoporosis, in which there is wide a variation in effectiveness and costs of therapeutic strategies. Aiming to identify relevant studies, there was a complete review of the economic evaluations, conducted in Brazil and abroad, focusing on the treatment of postmenopausal osteoporosis to support decision-making on health policies in Brazil and Latin America. METHODS: There was a search on PubMed and the national scientific journals until February 2011. We used the keywords {osteoporosis} and {postmenopausal or post-menopausal} and {cost effectiveness or cost benefit or cost utility or Economic Evaluation}. RESULTS: 147 titles and abstracts were found. After careful selection, 29 articles remained for analysis. We found great variability in the methods of studies related to the specific issues of each country (demographic and epidemiological factors), associated with the perspective adopted, the prices, the valuation of health states by population (utility) and according to factors inherent to economic modeling. Most studies that compared treatment strategies with no treatment at all, found a reasonable incremental cost-effectiveness ratio (ICER), according to the willingness to pay of each country. The interventions have become more cost-effective with increasing age, decreasing bone mineral density and the presence of previous fractures. In general, bisphosphonates were the strategies that were evaluated the most and they showed better results in ICER's. Teriparatide was not cost-effective. Studies evaluating hormone replacement therapy found good ICER, but call attention to the increased risk of breast cancer. Vitamin supplementation, strontium ranelate, raloxifene, and denosumab were evaluated and showed variable results depending on the perspective, of the country and the assumptions. CONCLUSIONS: It was not possible to extrapolate any of the results to the population of Brazil or countries of Latin America, limiting its use to decision makers in yours different locations.