Asthma is a chronic inflammatory disease of the respiratory system in children and adults, with a prevalence ranging from 1-18% worldwide. It is estimated that over 330 million people worldwide have asthma, while osteoporosis, as the most common metabolic bone disease, is constantly increasing with an aging population and a longer life span. Osteoporosis and fractures associated with osteoporosis cause significant morbidity and mortality, as well as reduced functional capacity and decreased quality of life, which is a major public health problem. Inhaled corticosteroids, as the most effective anti-inflammatory medication in asthma control, are the mainstay asthma treatment. Inhaled corticosteroids are effective in reducing airway inflammation, controlling symptoms, and reducing the risk of future exacerbations and related decline in lung function. Although the adverse effects of systemic corticosteroids on bone metabolism and an increased risk of osteoporosis and consequent fractures are well known, reports of possible adverse effects during long-term treatment with high doses on bone mineral density and fractures are conflicting for inhaled corticosteroids. Therefore, the aim of this review is to evaluate the possible risk factors that increase the risk of osteoporosis in patients with asthma and to determine whether and to what extent inhaled corticosteroids affect bone metabolism, bone mineral density and the risk of osteoporosis and fractures in patients with asthma. The importance of osteoporosis prevention in patients with asthma who use inhaled and systemic corticosteroid therapy should be emphasized, in the form of bone densitometry measurements and risk assessment in each patient, with the initiation of appropriate treatment depending on the findings.