Osteoporosis is a metabolic bone disorder characterized by low bone mass, degradation of bone micro-architecture and susceptibility to fracture. It is a growing major health concern across the world, especially in the elderly population. Osteoporosis can cause hip or spinal fractures that may lead to high morbidity and socio-economic burden. Therefore, there is a need for early diagnosis of osteoporosis and prediction of fragility fracture risk. In this paper, state-of-the-art and recent advances in imaging techniques for diagnosis of osteoporosis and fracture risk assessment have been explored. A review of segmentation methods used to segment the regions of interest and texture analysis methods used for classification of healthy and osteoporotic subjects are also presented. Furthermore, challenges posed by the current diagnostic tools have been studied and feasible solutions to circumvent the limitations are discussed. Early diagnosis of osteoporosis and prediction of fracture risk requires the development of highly precise and accurate low-cost diagnostic techniques that would help the elderly population in low economies.