Orthodontic tooth movement needs simultaneous bone formation and resorption. Patients with high risk of bone resorption (osteoporosis), due to systemic problems, may have a deleterious effect on tooth movement. With increased adults seeking orthodontic treatment, the number of such patients seeking orthodontic treatment have increased in last few decades. It so has become of prime importance for an orthodontist to diagnose such patients and take necessary actions. This article will deal with osteoporosis in general, its pathophysiology, the signs, and symptoms, its effect on orthodontic tooth movement, its treatment, and the necessary actions to be undertaken by the orthodontist.