Osteoporosis is a prevalent skeletal disorder characterised by reduced bone density and structural deterioration, leading to increased fracture risk. Despite being a major public health concern, osteoporosis often remains underdiagnosed and undertreated due to its asymptomatic progression until a fracture occurs. This “silent disease” necessitates proactive screening, particularly in at-risk populations, and comprehensive management strategies to mitigate fracture risk and improve the quality of life. Key challenges in osteoporosis management include underdiagnosis, especially in younger patients or those with atypical joint involvement, and misinterpretation of bone mineral density results, the omission of using the FRAX tool, all which may not reflect true fracture risk. Other pitfalls include failure to initiate treatment following fragility fractures, over-reliance on calcium and vitamin D supplementation and inadequate attention to fall prevention and secondary causes of bone loss. Effective management requires a patient-centred approach encompassing timely pharmacologic interventions, tailored lifestyle modifications and regular follow-up to monitor disease progression and treatment response. Addressing these challenges can significantly enhance patients outcomes and reduce osteoporosis-related morbidity and mortality.