Osteoporosis is the deterioration of bone tissue and strength, which leads to an increased risk of fractures. Postmenopausal women are at increased risk for osteoporosis. Bisphosphonates have long been the mainstay of osteoporosis treatment to prevent fractures, especially hip fractures by increasing bone mineral density. Extending treatment to up to 10 years is currently recommended. In lieu of possible adverse events such as atypical fractures and osteonecrosis of the jaw, drug holidays are an important consideration although research is currently inconclusive. Providers need to consider individual patient factors and tailor treatment to individual patient circumstances.