Osteoporosis and other bone diseases are a major public health concern worldwide. Current
pharmaceutical treatments for bone disorders have limitations, driving interest in complementary
herbal medicines that can help maintain bone health. This review summarizes the scientific
evidence for medicinal herbs that modulate bone cell activity and improve bone mass, quality and
strength. Herbs with osteogenic, anti-osteoporotic, and anti-osteoclastic effects are discussed, including
compounds and mechanisms of action. Additionally, this review examines the challenges
and future directions for translational research on herbal medicines for osteoporosis and bone
health. While preliminary research indicates beneficial bone bioactivities for various herbs, rigorous
clinical trials are still needed to verify therapeutic efficacy and safety. Further studies should
also elucidate synergistic combinations, bioavailability of active phytochemicals, and precision approaches
to match optimal herbs with specific etiologies of bone disease. Advancing evidence-
based herbal medicines may provide novel alternatives for promoting bone homeostasis and
treating skeletal disorders.