48 women with postmenopausal osteoporosis were randomized to either a group which received a combination of strontium ranelate (SrRan) and alfacalcidol (alfa D3), a group which received SrRan, or a control group. All groups also received calcium and vitamin D3 supplementation. The purpose of this study was to compare the efficacy of SrRan in combination with alfa D3, and SrRan alone on bone mineral density and fall risk in postmenopausal women with osteoporosis. Outcomes were measured using functional tests and biochemical markers over a period of 6 months. The results demonstrated that the group which received SrRan + alfa D3 experienced greatly improved bone quality, markers of bone turnover, and functional performance on the Timed Up-and-go test, chair rising test, and equilibrium test compared to the control group and SrRan alone group.