Background <p>The association of obesity- related markers such as Visceral Adiposity Index (VAI) and Lipid Accumulation Product (LAP) and bone health is controversial. This study aimed to evaluate this association among men using data from of the second recruitment of the Bushehr Elderly Health (BEH) program.</p> Methods <p>A cross-sectional analysis was conducted on 851 men aged 50 years and older using data from the BEH program. Demographic information, laboratory data, bone mineral density (BMD) and trabecular bone score (TBS) were collected. Participants with a T-score ≤ − 2.5 at the lumbar spine, total hip, or femoral neck were classified as having osteoporosis, while others were not. Low BMD (osteopenia/osteoporosis), was defined as a T-score ≤ − 1 at any of these sites. Associations of adiposity measures and bone health were investigated using linear and logistic regression analyses.</p> Results <p>The mean age of the participants was 62.9 ± 0.2 years and 151 (17.7%) were diagnosed with osteoporosis. Compared to individuals without osteoporosis, those with osteoporosis had lower mean of VAI (2.3 vs. 2.7, <i>p</i> = 0.001) and LAP (44.5 vs. 61.6, <i>p</i> &lt; 0.001). After adjusting for known and measured confounders, VAI exhibited a positive association with BMD at total hip and LAP exhibited a negative association with TBS. Each one unit increases in VAI was associated with 0.0192 gr/cm² increase in lumbar spine BMD, while one-unit increase in LAP was associated with 0.0011 gr/cm² decrease in TBS. Moreover, in logistic regression analysis, VAI was related with lower odds of having low BMD (odds ratio = 0.725, <i>p</i> = 0.041).</p> Conclusion <p>These findings highlighted that some adiposity parameters may serve as valuable markers in evaluating bone health in older adult men. A deeper understanding of these associations may improve clinical approaches for the prevention and management of osteoporosis in this population.</p>