Bone mineral density (BMD) is thought to be under strong genetic control. Polymorphisms of the vitamin D receptor (VDR) gene have recently been suggested to account for some of the genetic variations in bone mineral density in Caucasians. However, the relationship between VDR genotye and BMD remains still controversial. As the start codon polymorphism (SCP) of VDR gene has been suggested to be related to bone mineral density and fracture, we examined the relationship between VDR start codon polymorphism (SCP) and osteoporosis in postmenopausal Korean women In this study. The SCP defined by Fok I and BMD were assessed in 262 (80 premenopausal, 182 postmenopausal) healthy Korean women, 162 postmenopausal women were further analyzed according to the presence of osteoporosis (52 with spine osteoporosis, 38 with femoral neck osteoporosis, and 72 without osteoporosis). BMD at the 2nd to 4th lumbar spine, femoral neck, greater trochanter, and Ward's triangle were measured by dual energy X-ray absorptiometry using a Lunar DPX-L. BMD was adjusted for age, weight, height, and years since menopause (YSM) or menopausal status before analysis. The frequency distribution of Fok Igenotype were: ff, 14.5%; Ff, 48.1%; FF, 37.4%. There was no significant relationship between Fok I-RFLP and BMD measured at the 2nd to 4th lumbar spine and femur in all subjects. Neither was there any significant relationship between SCP and osteoporosis of spine or femoral neck. Logistic regression analysis revealed that age and BMI significantly affect the spine and femoral neck osteoporosis. These results indicate that SCP does not significantly affect BMD of spine or femoral neck and osteoporosis in Korean women.