OBJECTIVE:: To investigate the relationship between osteoporosis and nutritional status as determined by the Mini-Nutritional Assessment (MNA). DESIGN:: A cross-sectional study. SETTING:: Stockholm, Sweden. SUBJECTS:: A total of 351 elderly free-living women (mean age 73±2.3 years). METHODS:: MNA (range 0-30 points; <17 indicates malnutrition, 17.5-23.5 risk of malnutrition and ≥24 well nourished), measurements of bone mineral density of the left hip and lumbar spine using Hologic QDR 4500, and of the heel using Calscan DEXA-T. RESULTS:: The median MNA score was 27 (range 12.5-30). One woman was classified as malnourished and 7.4% were at risk of malnutrition. Osteoporosis of the femoral neck was observed in 22% and a fracture after the age of 50 was reported by 31% of the participants. The following items in the MNA questionnaire exhibited an increased risk of having osteoporosis in the femoral neck and/or total hip: an MNA score of <27 (odds ratio (OR) = 2.09; CI = 1.14-3.83); a mid-arm circumference of less than 28 cm (OR = 2.97; CI = 1.29-6.81); and regular use of more than 3 drugs each day (OR = 2.12; CI = 1.00-4.50). A body weight of more than 70 kg exhibited a decreased risk of having osteoporosis (OR = 0.31; CI = 0.14-0.70). CONCLUSIONS:: In general, the nutritional status was good in this population of free-living elderly women. Nevertheless, half of the women who displayed an MNA score <27 points had a twofold increased risk of having osteoporosis. SPONSORSHIP:: Karolinska Institutet, Stockholm County Council.