<i>Summary</i> <p>Older women of a South Asian heritage are at higher risk of osteoporosis yet remain less likely to access healthcare services for support with osteoporosis. Our study found sociocultural and religious factors shape their decisions. Designing culturally tailored services can help South Asian older women access timely osteoporosis support.</p> Purpose <p>To explore South Asian older women’s beliefs and experiences of living with osteoporosis, with the aim of informing health service delivery.</p> Methods <p>Eleven older women with a self-reported diagnosis of osteoporosis were conveniently selected from community organizations in West Yorkshire, UK. Data were collected between September 2024 and March 2025. In-depth semi-structured interviews were audio recorded, transcribed, and analyzed using constructivist grounded theory.</p> Results <p>Four themes were identified; a perceived natural physical deterioration, beliefs about causes of osteoporosis, impact of osteoporosis, and adapting to living with osteoporosis. Osteoporosis was perceived as natural physical deterioration which occurred as an inevitable part of the ageing process. It was also perceived to be associated with existing health conditions and viewed as ordained by God. Osteoporosis impacted lives of South Asian older women by causing loss of familiar routine, loneliness and social isolation, and negative emotions. However, South Asian older women adapted to living with osteoporosis through family-based support, traditional remedies and practices, and using religion as a coping strategy.</p> Conclusion <p>South Asian older women’s sociocultural perspectives and emotional and coping strategies for managing osteoporosis influenced decisions to access healthcare services. It is imperative for health providers to consider the individual meaning of osteoporosis for this population in relation to their specific needs, to improve engagement with osteoporosis healthcare and support services.</p>