Osteoporosis is a systemic bone metabolism disorder characterized by reduced bone mineral content, damaged bone microstructure and compromised bone strength that may predispose to an increased risk of fracture and an increased bone fragility. Warfarin, a vitamin K antagonist, can inhibit carboxylation of osteocalcin, reduce bone calcium deposition, and thus interact with bone metabolism and induce osteoporosis or bone fracture, especially in the elderly patients. The osteoporosis risk related with the use of warfarin may be associated with dosage and time of duration. The basic principle to prevent drug-induced osteoporosis is the same as that for primary osteoporosis. Calcium and vitamin D should be used for prevention. Bisphosphonates, calcitonin, estrogens and parathyroid hormone analogues can be selected for the treatment of osteoporosis or fracture induced by warfarin according to the individual condition of patients. In this paper, we reviewed the advances on pathological mechanism, research progress and therapeutic strategy of osteoporosis induced by warfarin.