Aim: The study aimed to determine the prevalence of osteoporosis among post-menopausal women with vertebral fractures and identify the contributing demographic, clinical, radiological, and biochemical factors. Material and Methods: This observational, cross-sectional study was conducted in the Orthopedic Department over one year. A total of 80 post-menopausal women diagnosed with vertebral fractures were enrolled using purposive sampling. Data collection involved demographic questionnaires, Bone Mineral Density (BMD) assessment via DEXA scans, radiological evaluations, and biochemical marker analysis. Statistical analysis was performed using SPSS version 22.0, with a significance level set at p<0.05. Results: The mean age of participants was 65.42 ± 7.85 years, and the mean BMI was 24.78 ± 3.42 kg/m². A majority (62.50%) were diagnosed with osteoporosis, with significantly reduced T-scores across the lumbar spine, femoral neck, and hip regions. Radiological evaluations revealed that 62.50% had multi-level fractures, and biochemical analysis showed low serum vitamin D levels (18.20 ± 4.25 ng/mL) with elevated parathyroid hormone (75.2 ± 15.3 pg/mL). Multiple regression analysis identified age, BMI, menopausal age, family history of osteoporosis, and vitamin D levels as significant predictors of osteoporosis (R² = 0.72, p<0.05). Conclusion: The study revealed a high prevalence of osteoporosis among post-menopausal women with vertebral fractures. Age, BMI, menopausal age, family history of osteoporosis, and vitamin D deficiency were significant contributing factors. These findings highlight the need for early screening, preventive strategies, and targeted interventions to reduce osteoporosis-related complications in this population.