The decision to initiate anti-osteoporotic treatment in Denmark relies on the presence of risk factors combined with a low bone mineral density or on previous low energy fracture, but does not take into account factors like residual life expectancy or the complex relationship between age, bone mineral density and risk factors. The WHO FRAX tool estimates the ten-year risk of osteoporotic fractures by superimposing national fracture and mortality rates on a generalized risk model derived from large studies. As a version adapted for Denmark has now become available, we discuss the strengths and limitations and the impact on clinical decision-making and health policy.