» Proton pump inhibitors (PPIs) are widely prescribed medications that are utilized for the treatment of gastroesophageal reflux and similar gastrointestinal disorders in all patient populations. » There is evidence that prolonged use of PPIs can lead to osteoporosis and altered bone metabolism and can even affect developing bone in pediatric patients. » There is evidence that the use of these medications increases the risk of fractures in pediatric and adult patients, including fragility fractures of the hip and spine in elderly patients. » There is preclinical evidence that the use of PPIs can affect bonehealing after fracture, delaying callus formation and altering the biomechanics of healing bone. » Orthopaedic surgeons, primary-care managers, and gastroenterologists should consider these risks when their patients are receiving prolonged PPI therapy, and the risks and benefits of PPI use should be taken into account when tailoring PPI use to each individual patient.