Background Coronary heart disease and osteoporosis are common diseases in the elderly, which have high mortality. Objective: To study the relationship between osteoporosis and coronary heart disease in the elderly.Methods 345 elderly patients (> 60 years) were randomly selected to investigate the basic information, biochemical indicators, bone mineral density (BMD), and bone turnover markers (BTMs). The relationship between osteoporosis and coronary heart disease in the elderly was studied by recording and statistical analysis.Results There were significant differences in gender, age, body mass index (BMI), hypertension, diabetes, smoking, drinking, and BMD (P < 0.05) in the coronary heart disease group, while no significant difference was observed in heart rate, Ca, P, OC, and CTX (P > 0.05). Osteoporosis was an independent risk factor for coronary heart disease in the elderly, and BMD was negatively correlated with the modified Gensini score and Agatston score.Conclusion Osteoporosis in the elderly is closely related to coronary heart disease and is an independent risk factor of coronary heart disease. The lower the BMD, the higher the risk of coronary heart disease.