Dual X-ray laser (DXL) heel measurements of bone mineral density (BMD) and dual energy X-ray absorptiometry (DEXA) total hip and lumbar spine BMD measurements were compared for their ability to detect osteoporosis and osteopenia according to World Health Organization criteria. The study included 164 women aged 40 - 83 years. DXL heel measurements were recorded for all patients and 89 of the women underwent DEXA. For DXL heel measurements/DEXA lumbar spine measurements, the relative sensitivity was 50%, relative specificity was 97% and relative reliability (Kappa score) was 0.55 for osteoporosis detection. For detecting osteoporosis or osteopenia, the relative sensitivity increased to 86% but the relative specificity reduced to 38% and the relative reliability was considerably lower (Kappa score 0.21). Although previous studies have shown DXL heel measurement to be a good technique in the diagnosis and assessment of osteoporosis based on BMD, particularly for fast, cost-effective bone scanning, we suggest that there are currently insufficient data to prove its use as a standard measurement technique for BMD.