The risk of fracture in patients with osteoporosis secondary to chronic kidney disease (CKD) increased significantly, which seriously affected the quality of life and increased mortality. Standardized management of osteoporosis secondary to CKD is very important. Abnormal mineral metabolism caused by declined glomerular filtration rate is an important factor leading to osteoporosis in patients with CKD. For clinical diagnosis and evaluation of osteoporosis secondary to CKD, it is recommended to assess biochemical indicators according to the KDIGO guideline, detect the bone mineral density regularly, and predict osteoporosis fracture risk with the risk prediction tools such as the self-assessment tool for Asians (OSTA) and the fracture risk assessment tool (FRAX). For management of osteoporosis, the key is prevention, and treatment should be individualized; and if necessary, besides basic therapy, drug therapy can be employed, including active vitamin D, bisphosphonates, and calcitonin, etc, but the indications should be strictly controlled because the safety of the drugs in CKD patients should be considered to avoid serious clinical problems like hypercalcemia and vascular calcification, and so on.