Aim: To determine the proportion of patients admitted to a major tertiary teaching hospital in Australia aged 50 years and older with a confirmed neck of femur or vertebral minimal trauma fracture, who are commenced on specific antiosteoporosis therapy by discharge, and to describe the agents prescribed. Methods: A retrospective analysis was conducted using patients’ electronic medical files of patients admitted with a minimal trauma fracture of the hip or vertebra during a 6 month period. Results: A total of 407 patients were audited and 64 patients were included in the study; 37 were admitted for a fractured hip and 27 were admitted for a vertebral fracture. Of these 64 patients, a total of 14 (21.9%) patients were commenced on specific anti-osteoporosis therapy. Denosumab (71%) was the most commonly initiated treatment, followed by risedronate (21%) then alendronate (7%). Conclusion: Majority of patients presenting to hospital with a minimal trauma fracture were not commenced on anti-osteoporosis therapy in hospital. This is a missed opportunity for intervention that may place patients at a higher risk of subsequent fracture; therefore effective strategies should be implemented to address this treatment gap in the future.