OBJECTIVES: To evaluate the effects of 3-year hormone therapy, raloxifene and alendronate on lipid profile and body mass index (BMI) in Korean postmenopausal women. METHODS: We studied 107 postmenopausal women who had visited the Department of Obstetrics and Gynecology of Inje University Sanggye Paik Hospital between January 2000 and June 2010. These patients were divided into alendronate (n=21), raloxifene (n=18), estrogen therapy (ET) (n=35), estrogen-progesterone therapy (EPT) (n=33) group. Serum lipid profile was measured at baseline and 1, 2, 3-year after treatment. BMI were also assessed at baseline and 3-year after treatment. RESULTS: Total cholesterol level was decreased significantly after 3 years of treatment in EPT group by 5.0% and raloxifene group by 8.7%. Triglyceride level was decreased significantly after 3 years in alendronate group by 12%. HDL-cholesterol level was increased significantly after 2 years in ET group by 12% and EPT group by 6.0%. LDL-cholesterol level was decreased significantly after 1 year in ET group by 7.0% and EPT group by 13%. In raloxifene group, LDL-cholesterol level was decreased significantly after 3 years by 7%. BMI was not changed significantly after 3 years in all four groups. CONCLUSIONS: In postmenopausal women, the treatment with hormone therapy or raloxifene has a beneficial effect on lipid profiles. BMI was not changed.