Osteoporosis is a degenerative disease characterized by reduced bone quality and strength, which can lead to brittle fracture, but it is often not fully treated and diagnosed in clinical practice. Bone metabolic markers play an irreplaceable role in the diagnosis and treatment evaluation of osteoporosis. This paper reviews the common bone metabolic markers and their application in the diagnosis and treatment of osteoporosis, providing more detailed and accurate reference and ideas for the clinical diagnosis and treatment of osteoporosis.