The World Health Organization Fracture Risk Assessment Tool (FRAX) and the National Osteoporosis Foundation's (NOF) Clinician's Guide to Prevention and Treatment of Osteoporosis are helpful clinical tools in the management of osteoporosis. Appropriate use of these tools requires a clear understanding of their limitations as well as their benefits. Good clinical judgment should be the ultimate determinant of treatment decisions. We anticipate that further refinements to FRAX and subsequent updates of the NOF guide will improve their clinical utility.