Children who have disabilities are at increased risk for osteoporosis during childhood. This not only puts them at risk for fractures during childhood but also during adulthood. Peak bone mass, which helps predict osteoporosis in adulthood, is never attained in children who have a disability. Care providers of this group of children must be aggressive in the prevention and treatment of osteoporosis. A thorough laboratory evaluation and DXA studies may be undertaken on all disabled children who are at risk for osteoporosis. Although medications have shown promise in the treatment of decreased bone mass, their efficacy in children who have disabilities must be evaluated in larger, controlled studies. Nonpharmocologic treatments also necessitate further exploration.