Genome-wide analyses indicate vitamin D, through its active metabolite 1,25-dihydroxyvitamin D 3 (1,25 (OH) 2 D 3 ) and the vitamin D receptor (VDR), has a potential to regulate the expression of some 3000 genes [1]. However, current evidence indicates that the strongest phenotype exhibited by vitamin-D-deficient humans or animals relates to impaired skeletal health. The first scientific reports in the early 1900s that rickets was due to vitamin D 3 deficiency placed vitamin D as central to the regulation of calcium and phosphate homeostasis. In this context, it appears that the most critical and most widely studied endocrine role of vitamin D is its contribution to the maintenance of plasma calcium and phosphate at physiological levels through regulation of intestinal absorption of dietary calcium and phosphate.A central question, however, is whether vitamin D acts directly on bone tissue to modulate bone mineral homeostasis and bone strength. This question has been difficult to answer conclusively due in part to the direct actions of vitamin D on plasma calcium and phosphate levels, which indirectly affect bone mineralization and structure. One direct action that has been clearly demonstrated is the ability of plasma 1,25(OH) 2 D 3 , at least at supraphysiological levels, to stimulate bone resorption by the activation of osteoclasts [2].The effects of vitamin D deficiency on bone in vivo can apparently be largely corrected by increasing dietary calcium and phosphate [3,4], suggesting that vitamin D is not an absolute requirement for optimal bone health. Indeed, the fact that the osteomalacic phenotype observed in the vitamin D receptor gene knockout (Vdr KO ) mouse can be rescued by feeding a diet containing high levels of calcium and phosphate has led some to conclude that VDR-mediated activity in bone is essentially redundant [5,6]. Others have suggested that actions of VDR in bone may in fact impair mineralization [7,8]. These conclusions are, however, difficult to reconcile against an accumulating large body of evidence indicating that vitamin D activity in bone is critical for bone cell differentiation and optimal mineral status [9e12]. In this chapter, we examine the evidence for direct effects of vitamin D on the bone as a tissue, and its actions on the constituent cells of bone, in particular bone-matrix-forming osteoblasts, osteocytes, and bone-resorbing osteoclasts.There is now evidence that each of the major bone cells is capable of producing 1,25(OH) 2 D 3 from the 25-hydroxyvitamin D 3 (25(OH)D 3 ) precursor, and that this activity is likely to account for the skeletal effects of circulating 25(OH)D 3 (see Fig. 23.1). On the weight of this evidence, we have proposed that bone is an intracrine organ of vitamin D metabolism [13]. The actions of 1,25(OH) 2 D 3 are mediated ultimately by direct effects on individual vitamin-D-responsive genes. However, the effects of vitamin D on bone tissue as a whole are not yet fully understood but are likely due to a combination of direct effects via VDREs, downstr...