The bisphosphonates (BP) are well established as the treatment of choice for disorders of excessive bone resorption. Their classical pharmacological effects appear to result from two key properties: affinity for bone mineral and inhibitory effects on osteoclasts. Presented paper contains overview of the most important information concerning application of bisphosphonates in orthopedics. This compilation has been extended and includes also cellular mechanisms of action, pharmacological classification as well as adverse effects of this drugs' group. The most significant differences between the various individual BP and basic pharmacokinetic properties have been shown. This manuscript presents clinical guidelines on safe bisphosphonates usage.