Abstract: Objective To investigate the change and the significance of bone mineral density and biochemical indexes of bone metabolism in middle-aged and elderly women. Methods 2446 cases of female inpatients and outpatients, aged 40 years or more had been enrolled from January 2010 to June 2013. They were divided into three groups according to age, 40 to 49years old, 50 to 59years old and ≥60years old groups. They received BMD scanning with quantitative ultrasonic bone density apparatus according to the conventional method; and serum procollagen type I -terminal propeptide (PINP) and beta-isomerized C-telopeptide (β-CTx) were measured by Roche ECLIA. The serum 25-hydroxyvitamin D (25(OH)D) and tartaric acid phosphatase-5b (TRACP-5b) were determined by enzyme linked immunosorbent assay. Results The bone mineral density were significantly reduced with age (P<0.01), while the serum level of PINP were increased observably with age (P<0.05). The bone mineral density in group less than 60 years old increased more obviously than group 40 to 49 years old (P<0.05). The serum level β-CTx were increased observably with age (P<0.01), The serum level β-CTx in group of 50 to 59 years old and over 60 years old increased more significantly than group of 40 to 49 years old (P<0.05). The TRACP-5b values in the group less than 40 to 49 years old were minimum, the group aged more than 60 came second，and the group aged 50 to 59 showed maximum. The bone resorption beta CTx and TRACP-5b value increased more obviously than bone formation PINP value. The serum concentrations of 25-hydroxyvitamin D showed low values as a whole, all in the lack of state (P<0.01). Conclusion Middle-aged and old women vitamin D nutritional status is generally poor. Elderly women's bone mass loss is more obvious, and bone fracture occurs more obvious. Combined detection of bone mineral density and bone metabolism biochemical indexes, which provide the basis to strengthen the health care work of middle-aged and old women, have certain clinical significance to reduce the incidence of osteoporosis.