OBJECTIVES: To investigate the incidence of non-responder to hormone therapy (HT) and to evaluate the bone response to HT according to basal bone mineral density(BMD) in postmenopausal women. METHODS: A total of 167 postmenopausal women received either continuous combined estrogenprogestogen replacement (n=102) or estrogen replacement (n=65) for 1 years. BMD at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry (DXA) before and 1 year after HT. RESULTS: The incidence of non-responder (women with >3% bone loss per year) to HT was 8.3% in the lumbar spine, and 22.1% in femoral neck. non-responder group had a higher basal BMD at the lumbar spine than responder group, and showed bone loss rate of 7.7% per year. After 1 year of HT, postmenopausal women with osteoporosis showed a higher rate of increase in BMD at the lumbar spine and femoral neck than women with normal BMD or osteopenia. CONCLUSIONS: The non-responders to HT have a higher basal lumbar BMD, compared with responders. The higher basal BMD at the lumbar spine is, the less bone conservation effect of HT is.