Background: Osteoporosis and related fractures are associated with significant morbidity and reduced Health-related Quality of Life (HRQoL). The objective of this study was to measure the HRQoL of osteoporosis patients in Tehran, the capital city of Iran. Method: We surveyed a sample of 478 patients with osteoporosis aged over 50 years with and without osteoporotic fractures. Patients with osteoporotic fractures (hip, vertebral, and forearm) admitted to the educational hospitals affiliated to

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... e Tehran University of Medical Sciences-Iran, during 2017 were randomly selected. Patients without osteoporotic fractures were also randomly selected among patients with a definite diagnosis of osteoporosis who were referred to three outpatient clinics in Tehran during 2017. Data were collected using the EQ-5D-5L questionnaire. Statistical differences between patients with and without a history of fracture were tested with Pearson's χ2 test, Student's t-test and Mann–Whitney U-test. The association between HRQOL and other variables was evaluated using a multiple linear regression model.Result: The mean ±SD age of the patient was 67.3±11.9 years, and 65% were women. A hundred and seventeen (23%) patients had hip fractures, 56 (11%) patients had vertebral fractures, 127 (25%) patients had forearm fractures and 178 (40%) patients had no fractures. The median (interquartile range) values of HRQOL scores of those with hip, vertebral, and forearm fractures and those with no history of fracture were 0.53 (0.22), 0.60 (0.28), 0.64 (0.26), and 0.64 (0.27), respectively. According to the result of multiple regression model there was a significant relationship between the HRQoL scores and gender, marital status, employment status, presence of any chronic illness in addition to osteoporosis and type of fracture.Conclusion: Osteoporosis and related fractures significantly reduced HRQoL. Due to the significant negative impacts of the osteoporosis on HRQoL and healthcare expenditures, Intervention strategies should be tailored to prevent it and to improve the HRQoL of osteoporosis patients.