The prevalence of osteoporotic fractures continues to increase globally as the world population of older adults, in particular those aged 85 years and over, increases. Osteoporotic fractures are associated with significant morbidity, mortality, and health care expenditure. Although the number of osteoporosis therapies have expanded over the last few decades, the majority of available antiresorptive and anabolic drugs only modestly reduce non-vertebral fracture rates, which account for approximately 80% of all fragility fractures. Hence, there is an ongoing need for more effective drugs or therapeutic regimens with improved fracture risk reduction. In this presentation, I will describe advances in combination antiresorptive/anabolic treatment approaches, with a focus on combined denosumab and teriparatide regimens, which appears to be the most promising combination approach for postmenopausal osteoporosis, evaluated to date.