OBJECTIVES: The purpose of this study was to compare the differences in bone mineral density (BMD), T-scores, and the prevalence of osteopenia and osteoporosis between mountain villagers and seaside villagers. MATERIALS & METHODS: Four hundred fifty-one postmenopausal women (138 women in mountain villagers and 313 women in seaside villagers) were examined, including women > 50 years of age. The study subjects were recruited from the women who had received care at the health examination center of our hospital between January 2005 and September 2009. The BMD was measured at lumbar 1-4 by dual-energy X-ray absorptiometry. RESULTS: The average BMD of the lumbar spine in seaside villagers was higher than mountain villagers (0.959 g/cm2 vs. 0.996 g/cm2, P=0.011). The average T-score of seaside villagers was also higher than mountain villagers (-1.31+/-0.10 vs. -0.98+/-0.07, P=0.008). The prevalence of osteopenia in mountain villagers was higher than that in seaside villagers (55.8% vs. 39.0%, P=0.001); however, the prevalence of osteoporosis between the two groups was not significantly different. CONCLUSIONS: Gyeongnam seaside villagers recorded higher values in lumbar BMD and T-scores than their mountain neighbors, showing lower risk of osteopenia. Both villagers have the same risk for osteoporosis.