OBJECTIVES:: To assess the serum of 25-hydroxyvitamin D (25(OH)D) and intact parathyroid hormone (iPTH) levels in postmenopausal women from northern China with hip and upper limb fractures. DESIGN:: Case–control. SETTING:: Affiliated Hospital of Qingdao University. PARTICIPANTS:: Postmenopausal women diagnosed with hip fracture (n = 335) and matched controls without fracture (n = 335). MEASUREMENTS:: Between 2011 and 2013, fasting venous samples were analyzed for 25(OH)D, iPTH, alkaline phosphatase (ALP), calcium, and phosphorus. All women completed a standardized questionnaire designed to document putative risk factors for fractures. RESULTS:: Eight percent of participants had vitamin D deficiency, and 66.0% had secondary hyperparathyroidism. Serum 25(OH)D levels were significantly (P < .001) lower in women with hip fracture than in controls. Multivariate logistic regression analysis adjusted for common risk factors showed that serum 25(OH)D of 20 ng/mL or less was an independent indicator of hip fracture (odds ratio (OR) = 2.98, 95% confidence interval (CI) = 2.11–4.20) and concomitant upper limb fracture in those with existing hip fractures (OR = 4.77, 95% CI = 1.60–10.12). The area under the receiver operating characteristic curve of 25(OH)D was 0.77 (95% CI = 0.68–0.84) for hip fracture and 0.80 (95% CI = 0.72–0.89) for hip and upper limb fractures. CONCLUSION:: Vitamin D insufficiency and secondary hyperparathyroidism were a common problem in postmenopausal women who presented with concomitant hip and upper limb fractures, suggesting that they might contribute to the pathophysiology of fractures in postmenopausal women.