The purpose of this study was to describe the care practices rural older women use to manage their osteoporosis and maintain their quality of life. One hundred and one rural older women, ranging in age from 68 to 92, were interviewed about their medical treatments, personal care practices, and the challenges they face in managing osteoporosis in their daily lives. The majority of women were diagnosed with osteoporosis between 1 and 5 years ago; one-third had experienced an osteoporotic fracture. Sixty-two percent of the women reported having pain associated with their osteoporosis,which often interfered with their ability to carry out daily activities and participate in social activities. The women used multiple health-, home-, and education-related strategies to manage their osteoporosis. One-third of the women reported having to rely on others to do things for them because of their osteoporosis, and one-half of these women indicated that their osteoporosis interfered with their family relationships at least some of the time. Compared with their other health problems, 41% said their osteoporosis had less influence on their quality of life, 47% indicated that it had about the same influence, and 13% reported that it influenced their quality of life more than their other health problems. The findings indicate that osteoporosis encompasses all aspects of the women's lives and suggest the importance of future research to further examine the relationship among disease processes and consequences, care practices, and quality of life of rural older women.