摘要Glucocorticoid is widely used in anti-inlfammatory and immune-modulatory drugs while its related side effects shouldn’t allow to be neglected, such as osteoporosis, diabetes, and obesity. Clinical applications of it has also been greatly restricted. Improvement of results of these unnecessary outcomes also become the main challenge of medical work. To explore the pathogenetic mechanisms of glucocorticoid-induced osteoporosis ( GIO ) and its effects on bone and mineral metabolism are of crucial importance. Endogenous glucocorticoid of physiological-concentration is not only a key regulating factor for differentiation of mesenchymal stem cells and bone development, but also involved in regulating calcium handling by kidney and gastrointestinal tract. As supra-physiological concentration, it acts as a “double-edged sword” role, taking unfavorable effect in the same tissue. Over the years there has been a controversial paradox about GIO mechanism for the anabolic and catabolism of glucocorticoid, which needs to be further in-depth studied. This paper reviews highlighted recent advances on physiology and pathology of glucocorticoid for bone metabolism, and to provide new strategies for prophylaxis and treatment of GIO.