In the shortterm, bisphosphonates show some effectiveness in preventing vertebral fractures demonstrated by x-ray. The efficacy with regard to preventing hip fractures is uncertain; for primary prevention hip fractures are not reduced and for secondary prevention the effect is of small magnitude and of questionable clinical relevance. In the long-term, there is an increased risk of atypical fractures affecting the subtrochanter and diaphysis of the femur. In addition, one cohort study suggests the incidence of hip fractures could be increased instead of reduced. Clarification of the long-term effects of bisphosphonates is therefore necessary and suspension of the use of these drugs for osteoporosis should be considered.