OBJECTIVES: Well-documented evidences have recommended patients who experience hip or spine fracture to receive anti-osteoporosis drugs. However, a treatment gap in pharmacological prevention of subsequent osteoporotic fractures was a current concern. This study aims at evaluate the treatment gap and prescription pattern of anti-osteoporosis drugs in Taiwanese population.  METHODS: Using Taiwan’s National Health Insurance Research database (NHIRD), we identified patients with a diagnosis of osteoporosis or users of anti-osteoporosis drugs [bisphosphonate, raloxifene, denosumab or teriparatide] from 2008 to 2013 as an osteoporosis cohort. From this cohort, we further identified those who were newly diagnosed with hip or spine fracture within 2009-2012 as our study subjects. The first diagnosis date of hip or spine fracture was defined as the index date for each of our study subject. Treatment gap were measured as the proportion of receiving anti-osteoporosis drugs within one year after the index date among our study subjects. The categories and timing of initiating anti-osteoporosis drugs were also examined. RESULTS: Our study included 283,399 patients with newly diagnosed hip or spine fracture between 2009 and 2012. Approximately two-third of them were female. The mean age of our study subjects were 67 and 71 years old for male and female, respectively. Treatment gap of post osteoporotic fractures differed by gender. The proportion of patients received anti-osteoporosis drugs within one year after the index date ranged from 10 to 15 % for male and 26 to 32% for female. Alendronate was the most frequently prescribed anti-osteoporosis drug for our study subjects. More than 50% of anti-osteoporosis drug users received their first prescription within 28 days after the index date. CONCLUSIONS: The proportion of patient received treatment within one year after index fracture was suboptimal in Taiwan, especially for male. More effects are warranted to improve the post-fracture care in Taiwanese patients.