Summary-Using administrative data healthcare databases from five Canadian provinces, we compared prevalence estimates of diagnosed osteoporosis and incidence rates for related fractures in Canada. The algorithms adopted showed consistent age and sex patterns across all provinces and will be suitable for national surveillance and monitoring.Purpose-This study aims to evaluate the feasibility of using provincial population-based administrative data to develop a national surveillance system of diagnosed osteoporosis and related fractures (forearm, humerus, vertebra, pelvis, and hip) in Canada.Methods-Linked healthcare databases from five provinces representing approximately 85 % of the Canadian population were used. Multiple algorithms combining hospitalizations, physician visits, and osteoporosis prescription drug dispensations were evaluated in each province. The adopted algorithms for diagnosed osteoporosis and incident fractures combined hospitalizations and physician visits based on 3 years and 1 year of data, respectively. Sex-specific agestandardized osteoporosis prevalence and fracture incidence rates were estimated for each province from