Objective: To analyze the scale, population distribution, institutional flow and funding sources of osteoporosis(OP) treatment in Shandong Province, so as to provide a reference basis for improving the prevention and treatment policies. Methods: Accounting and analysis based on “A System of Health Cost Accounting 2011". Results: In 2019, the treatment cost of OP for middle-aged and elderly people aged 50 and above in Shandong was 4259.9692 million yuan, accounting for 15.10 %of the total treatment cost in Shandong; According to the classification of fracture sites, the top three fracture sites are "hip (femur)" "pelvis, acetabulum, lumbar spine and sciatic fracture" “patella, fibula, tibia and ankle fracture" , and the total treatment cost accounts for 60.26%; treatment costs mainly flow to hospitals; total household health expenditure was about 2109.7239 million yuan, which was the main source of financing for treatment costs, accounting for 49.52 %. Conclusion: It needs to shift the prevention gate forward to enhance the awareness rate and screening rate related to OP; focus on prevention and treatment of hip fractures, and develop a refined reimbursement strategy based on specific sites; consolidate the foundation of grassroots capacity and strengthen the role of primary medical institutions to support the bottom; rely on the hierarchical diagnosis system to reasonably allocate medical resources for OP; optimize the composition of the funding scheme to reduce individual household expenditures.