Postmenopausal osteoporosis is a significant public health concern in India, contributing to fragility fractures, disability, and mortality among women. Estrogen deficiency after menopause disrupts bone homeostasis by enhancing osteoclast activity, resulting in accelerated bone loss and microarchitectural deterioration. Key risk factors include age, low body mass index, nutritional deficiencies, smoking, alcohol, comorbidities, and certain medications. Diagnosis is established through history, clinical examination, laboratory tests, and dual-energy X-ray absorptiometry (DEXA), with the FRAX tool aiding fracture risk prediction. Management strategies emphasize lifestyle modification, adequate calcium and vitamin D intake, fall prevention, and pharmacological therapy such as bisphosphonates, denosumab, selective estrogen receptor modulators, hormone therapy, and anabolic agents in high-risk cases. Regular monitoring of bone mineral density and treatment adherence is essential. Early screening and timely intervention are crucial to reduce the burden of osteoporotic fractures and improving quality of life in postmenopausal women.