OBJECTIVES: To investigate clinical manifestations of osteoporosis in the patients with stroke and define relationship between functional parameters and BMD. METHODS: The subjects were 43 female and 16 male stroke patients with cerebral infarction (n=40) and cerebral hemorrhage (n=19). Mean age of subjects was 74.19 years. Group 1 patients were 43 cases below three months of the duration from onset to the time to do BMD; group 2 were 16 cases above three months. Clinical parameters were BMD in lumbar spine and both femur of stroke patients, vertebral and femur fracture on radiographs, and relationship between functional parameters and BMD. RESULTS: Of the 59 stroke patients with stroke, 16 (27%) had vertebral fractures and 3 (5%) had femur fracture. There were no significant differences in spine and femur BMD between the two groups (P>0.05). Spasticity of upper extremity was related to BMD of femur in group 1. Motor power of lower extremity and spasticity of upper extremity were related to BMD of group 2 (P<0.05). The neurologic deficit and ADL were unrelated to the BMD of two groups (P>0.05). CONCLUSION: Results showed a high prevalence of vertebral fracture in the patients with stroke and there were correlated between BMD and severity of spasticity. Therefore early screening and active management of osteoporosis in the patients with stroke is crucial to prevent possible complications.