Purpose: We examined the relationship between the health-related issues of elderly women and bone density and identified specific factors that affect the prevalence of osteoporosis to provide basic data for developing a health care program on osteoporosis prevention. Methods: This study is a secondary data analysis of 118,903 66-yr-old women who received a health examination conducted by the National Health Insurance Corporation in 2008. Multiple logistic regression analysis was used to identify factors affecting the prevalence of osteoporosis. Results: The prevalence of osteoporosis was 46.8%, whereas the prevalence of osteopenia was 38.4% among elderly women in this study. Statistically significant differences were observed between the osteoporosis and non-osteoporosis group in terms of smoking (p<.001), exercise (p<.001), obesity (p<.001), waist circumference (p<.001), depression (p<.001), falling experience (p<.05), and the cognitive function risk (p<.05). Based on the multiple logistic regression results, the risk for osteoporosis was high in those who were under-weight, smoked, or were depressed. In contrast, moderate or high level obesity showed a negative relationship with osteoporosis. Conclusion: The prevalence of osteopenia and osteoporosis was 85.2%. Therefore, there is a need to develop health care programs pertaining to osteoporosis intervention and prevention for elderly women. Because smoking, non-exercise, and obesity are main osteoporosis risk factors, it is highly recommended that some sound practical life programs and psychological support programs be considered for this population.