Radiographic examinations for the presence of vertebral fracture between T4 and L5 were performed in a random sample of 85-year-old women (n = 304) and men (n = 158) who participated in a longitudinal study in Gothenburg. A vertebral fracture was defined as an anterior/posterior (A/P) vertebral height ratio of 0.66 or less. A severe vertebral fracture was defined as a compression of vertebral height of more than 33% both at the anterior and posterior edges compared to the posterior edge of the adjacent vertebral body. Bone mineral density was measured with dual photon absorptiometry in the right calcaneus. The most common site for vertebral fractures was L1 in women and Th12 in men. Bone mineral density in men at the age of 75 showed a significant correlation with vertebral fractures at 85 years of age (p < 0.001). This was not the case for women. Stepwise logistic analysis revealed that women with vertebral fractures at 85 years of age had more significant back pain, shorter stature, and more often a history of another fracture and/or chronic treatment with corticosteroids. In men, muscle strength, marital status and body weight at age 85 were the only factors significantly associated with vertebral fractures.