Alfacalcidol has shown its efficacy and safety in the treatment of patients with osteoporosis (OP) during various clinical studies. The article presents data from a study conducted in real clinical practice in order to assess the relevance of alfacalcidol in the treatment of OP patients and the patients' adherence to treatment. A survey of doctors and patients with OP and low-energy fractures was conducted. Alfacalcidol was prescribed by doctors in 27 % of cases, while in 19 % – in combination with antiresorptive drugs. Among the interviewed patients with the average duration of OP 3 years, 25 % of the respondents took alfacalcidol. Adherence to treatment during the last year was 38 %. Follow-up of patients after a low-energy fracture showed that 31 % of them received alfacalcidol, among whom treatment adherence for 36 months was 50 % for monotherapy, and 21 % for combination therapy. Thus, the survey showed that in real clinical practice, alfacalcidol is widely used both in the management of patients with OP and after low-energy fractures.