Objective: Basic science data, animal studies, and observational human studies suggest that the lipid-lowering cardiovascular family of statin medications might decrease fractures, increase bone density, and have a positive effect on bone turnover markers. The primary purpose of our review was to determine whether statins can prevent fractures in postmenopausal women; as secondary and explanatory factors, bone density and bone biomarker data were also evaluated. Methods: All randomized controlled trials assessing the effect of statins on bone mineral density were included; bone turnover markers and fractures in postmenopausal women were considered. Results: We identified six randomized trials involving 3,022 participants. Statins had no association with decreasing incidence of fracture. There was no statistical difference in the reduction in lumbar spine or total hip bone density. Other predictors of osteoporosis-related fracture risk, including markers relating to bone resorption (c-telopeptide of type I collagen and n-telopeptide of type I collagen) and bone formation (osteocalcin and bone-specific alkaline phosphates), did not show any significant changes. Conclusions: The trials included in our review, which included data on 3,022 women (mean age, >62.7 y), do not indicate that statin use prevents fractures or increases bone density. © 2010 by The North American Menopause Society.