Background: Osteoporosis presents itself as a multifaceted and diverse disorder. Smoking is widely acknowledged for its role in contributing to numerous health issues, among them osteoporosis and bone fractures. Consequently, this study was initiated to evaluate the prevalence of osteoporosis in individuals who smoke. Methods: The study encompassed 250 individuals who had a smoking history of at least 10 cigarettes per day over the past five years. Additionally, 250 non-smoking individuals were included as normal controls. Comprehensive demographic and clinical information for all participants was collected, including detailed medical and personal histories. Thorough clinical and oral examinations were conducted on all subjects, and the occurrence of osteoporosis was documented. Results: The overall incidence of osteoporosis was found to be 31.6 percent among smokers and 4.2 percent among non-smokers. Significantly higher rates of osteoporosis were observed in smokers compared to non-smokers. Among smokers with osteoporosis, 50.63 percent were in the age group of more than 45 years, and 34.81 percent were in the age group of 30 to 45 years. In the non-smokers group, 47.62 percent of individuals with osteoporosis were in the age group of more than 45 years, while 38.09 percent were in the age group of 30 to 45 years. Among both smokers and non-smokers with osteoporosis, 66.46 percent and 61.91 percent, respectively, were females. Conclusion: Smoking represents a substantial and well-established risk factor for the onset and progression of osteoporosis, a condition characterized by diminished bone density and increased susceptibility to fractures. The detrimental effects of smoking on bone health are attributed to several factors. Firstly, smoking has been linked to alterations in hormonal levels, particularly a decrease in estrogen in both men and women, which plays a crucial role in maintaining bone density. Additionally, smoking is known to interfere with the absorption of calcium, an essential mineral for bone strength, further compromising skeletal integrity.Moreover, the harmful constituents of tobacco smoke adversely affect bone-forming cells, impeding their ability to generate and maintain healthy bone tissue. The cumulative impact of these mechanisms underscores the significance of smoking as a risk factor in the development of osteoporosis. Recognizing and addressing this association is crucial for promoting bone health and preventing the adverse consequences of osteoporosis in individuals who smoke.