Osteoporosis leading to skeletal fragility is becoming prevalent in an ageing society. Consumption of food bioactive compounds, like vitamin K2 (menaquinone), is a viable strategy to prevent osteoporosis. Vitamin K2 plays an important role in bone health, especially calcium metabolism, by activating vitamin K-dependent proteins. This book chapter explores the biochemical mechanisms, clinical evidence, and dietary implications of Vitamin K2 in osteoporosis prevention. Vitamin K2 is essential for bone remodelling. It promotes bone formation by stimulating osteoblast differentiation and mineralisation while inhibiting osteoclast-mediated bone resorption. Epidemiological studies and human trials consistently demonstrate that Vitamin K2 supplementation improves bone mineral density, particularly in postmenopausal women. However, its effect on fracture risk remains inconclusive, necessitating further research. Despite its significance, vitamin K2 is often overlooked in dietary guidelines. The chapter advocates for its inclusion in public health recommendations, emphasising the need for further research to determine optimal dosages and explore its potential synergistic effects with other nutrients like vitamin D and calcium. Ultimately, integrating vitamin K2 into a holistic approach to bone health could lead to innovative strategies for osteoporosis prevention and overall well-being.