This review discusses two methods of monitoring the effect of anti-osteoporotic treatment: bone mineral density (BMD) and bone turnover markers (BTMs). Both monitoring strategies are to some extent able to predict the treatment-induced change in risk of fracture. The use of BMD is commonplace, and clinicians are experienced in the interpretation of data. The use and knowledge of BTMs among clinicians is limited, but it allows for early testing while being practical and cheap. Further knowledge and implementation of BTMs in the clinical practice may improve the monitoring capabilities.