The importance of ultrasound-based measuring methods in the diagnosis of osteoporosis has increased during the last few years. Measuring speed of sound (SOS) and broadband ultrasound attenuation (BUA) also allows assessment of density and elasticity of bone. Values measured show significant age dependence and correlate well with osteoporotic bone deterioration. The various ultrasound methods are quite equal and allow an adequate prediction of fracture risk comparable to the radiologic dual energy X-ray absorptiometry (DEXA) method. At present, standardization of cutoff points and criteria to determine osteoporosis among the different devices is unsatisfactory. The suitability of the method for a general screening is growing.