The coexistence of osteoporosis and sarcopenia has been recently considered in some groups as a syndrome termed ‘osteosarcopenia’. Osteoporosis describes low bone mass and deterioration of the micro-architecture of the bone, whereas sarcopenia is the loss of muscle mass, strength and function. With an ageing population the prevalence of both conditions is likely to increase substantially over the coming decades and is associated with significant personal and societal burden. The sequelae for an individual suffering from both conditions together include a greater risk of falls, fractures, institutionalisation and mortality. The aetiology of ‘osteosarcopenia’ is multifactorial with several factors linking muscle and bone function including genetics, age, inflammation and obesity. Several biochemical pathways have been identified which are facilitating the development of several promising therapeutic agents which target both muscle and bone. In the current review we outline the epidemiology, pathogenesis and clinical consequences of ‘osteosarcopenia’ and explore current and potential future management strategies.