Osteoporosis is a common metabolic bone disease characterized by low bone mineral density and an increased risk of fractures. Prevention and treatment strategies include lifestyle modifications that support bone health and the individualized use of pharmacological agents. Currently, pharmacological treatment options include bisphosphonates, selective estrogen receptor modulators, denosumab, anabolic agents, and romosozumab, in addition to calcium and vitamin D supplementation, lifestyle modifications, and regular physical activity. Treatment selection is guided by the patient`s fracture risk level, with more aggressive therapeutic approaches recommended for high-risk patients. In recent years, research on sequential and combination therapies has increased, emphasizing the need for individualized treatment plans. This review aims to provide an overview of osteoporosis prevention and current pharmacological treatment approaches, serving as a guide for clinical practice.