Chronic obstructive pulmonary disease (COPD) is being regarded as a disease with clinically significant pulmonary and extrapulmonary such as emphysema, cardiovascular disease and osteoporosis. Osteoporosis characterized by low bone mass and microarchitectural deterioration of tissue, leading to enhanced bone fragility and, consequently, an of fracture. Fractures resulting from osteoporosis might contribute to morbidity and mortality, particularly in COPD patients. The high osteoporosis in COPD patients is assumed to be due to common risk as older age and tobacco smoking, and COPD-specific risk factors, such systemic inflammation, vitamin D deficiency and the use of oral or corticosteroids. This review provides a state-of-the-art summary of the prevalence, pathophysiology, diagnosis, risk factors and treatment of osteoporosis in COPD patients. It also discusses potential mechanisms COPD with osteoporosis.