Background: Osteoporotic fractures are common - it has been estimated that one in two women and one in five men aged over 50 years will sustain at least one low trauma fracture in their lifetime. Objective: To determine the effect of Zoledronic acid on BMD in patients with fragility fracture. Methods: This Prospective single arm, Observational Cohort Study was conducted among Patients above the age of 40 years of either sex presenting with osteoporotic fracture to Department of orthopedics St. Martha’s Hospital, Nrupathunga road ,Bengaluru. Duration of Study was December 2015 to December 2017. Results: 46 % of the study population was between 71-80 years mainly from sedentary lifestyle. 96 %were postmenopausal women. 46 % of patients had fracture around hip, 40 % of patients had vertebral compression fractures and 14 % with distal radius fracture. Most of them were also noted to have additional vitamin D deficiency Conclusions: It was concluded that there is significant increase in BMD at 1 year of injection ZA. The Average BMD at the initial visit was- 0.65 gm/cm2, Average BMD 1 year later – 0.66 gm/cm2.