One thousand two hundred forty-five postmenopausal women were selected for this study. In postmenopausal women, the spine BMD levels (g/cm(2)) were significantly different in each subjects with normal (0.819+/-0.004), mild (0.846+/-0.007), moderate (0.844+/-0.009) and severe (0.779+/-0.031) fatty liver adjusted for age (P<0.01). The proportion of osteoporosis were significantly different in each subjects with normal (39.1%), mild (30.3%), moderate (31.6%) and severe (56.3%) fatty liver. A multiple logistic regressionanalysis was performed to determine the association between fatty liver and osteoporosis after age, body mass index, smoking, alcohol drinking and regular exercise. In severe fatty liver compared to the normal subjects of fatty liver, adjusted odds ratio was 3.6 (95% CI 1.2~10.9).