OBJECTIVE To investigate the osteoporosis risk profile of older home care clients and the prevalence of fracture and treatment within this group. METHODS A total of 1500 home care clients were randomly selected and mailed a survey. Overall, 874 (58%) of those surveyed completed and returned the survey. RESULTS A third (37%, n = 318) reported at least one fracture and 871(99.7%) reported at least one risk factor for osteoporosis. Despite this only 28% reported a diagnosis of osteoporosis, which was more likely if they had sustained a fracture. Bone mineral density tests were reported by 37.4% of respondents and 51.9% of those who had fractured. Only 34.5% who had fractured had been referred for an osteoporosis assessment following their fracture. CONCLUSIONS The home care clients surveyed have many of the risk factors associated with osteoporosis and fracture. A large number reported that they had already sustained fractures that can be attributed to osteoporosis. Despite this, a minority have been assessed or treated for osteoporosis.