Osteoporosis is frequently seen in patients with chronic obstructive disease (COPD). Since research on bone structure and bone strength in patients is limited, the objectives of this pilot study were: 1. To structure, stiffness and failure load, measured at the peripheral between men with and without COPD after stratification for areal bone density (aBMD), and 2. To relate clinical parameters with bone stiffness failure load in men with COPD. We included 30 men with COPD (normal aBMD osteoporosis n = 12) and 17 men without COPD (normal aBMD n = 9, 8). We assessed pack-years of smoking, body mass index (BMI), fat free (FFMI), pulmonary function (FEV1 , FEV1 /FVC, DLCO and KCO) and extent emphysema. Bone structure of the distal radius and tibia was assessed by resolution peripheral quantitative computed tomography (HR-pQCT), and stiffness and failure load of the distal radius and tibia were estimated micro finite element analysis (microFEA). After stratification for aBMD men with osteoporosis showed abnormal bone structure (p < 0.01), lower stiffness (p < 0.01) and lower failure load (p < 0.01) compared with men normal aBMD, and men with COPD had comparable bone structure, stiffness failure load compared with men without COPD. In men with COPD, lower related with lower bone stiffness and failure load of the radius and lower DLCO and KCO were related with lower bone stiffness and failure tibia after normalization with respect to femoral neck aBMD. Thus, this study could not detect differences in bone structure, stiffness and between men with and without COPD after stratification for aBMD. FFMI transfer capacity of the lung were significantly related with bone failure load in men with COPD after normalization with respect to aBMD. (c) 2013 American Society for Bone and Mineral Research.