A technology assessment report on biochemical markers for bone turnover in osteoporosis was abstracted in the Health Technology Assessment Database. It was not possible to predict an individual's fracture risk from the assessment of serum and urine biochemical markers of bone turnover, even if there is some population based evidence that increased values for biochemical markers are associated with increased fracture risk. Biochemical markers seem not to have adequate sensitivity and specificity to predict osteoporosis in individual, untreated patients, but there is no conclusive evidence from good quality trials. A combination of bone mineral density and biochemical marker measurements may be of greater value but the data are inconclusive. The diagnosis of osteoporosis is based on a reduced bone mineral density and/or the presence of fragility fractures. There is no conclusive evidence that biochemical markers may be used to assist in selecting the type of therapy from the different therapeutic options. Although biochemical markers have the potential to be used to motivate individuals to maintain a therapy program, there are no studies of the use of biochemical markers for this purpose.