Older adults have a higher prevalence of hypertension, and specifically systolic hypertension, than any other age group in the general population as the likelihood of developing hypertension during an average lifespan is high. Osteoporosis like hypertension is a chronic medical condition that can predispose the elderly to increased fracture risk. The relationship between hypertension, antihypertensive medications and osteoporosisrelated fractures is complex as hypertension and the medications used to treat hypertension such as thiazide diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers and beta-adrenergic blockers may have differential effects on bone. The purpose of this review is to provide an overview of the relationship between hypertension and bone and to examine the association between different antihypertensive medications on fracture risk in the elderly.