Bone marrow stromal/stem cells (BMSCs) are primitive and heterogeneous cells that containing osteogenic-bias, adipogenic-bias and other subsets, and their bone-fat lineage commitment is responsible for senile osteoporosis. However, there are little effective methods and evidence to simultaneously evaluate the lineage commitment of BMSCs. Here we provided a mixed osteo-adipogenic (OA) differentiation medium and established a method for simultaneous assessment of bone-fat lineage choice of BMSCs in vitro. The OA medium could simultaneously induce osteogenesis and adipogenesis in the same culture plate. Our results showed that the OA differentiation medium could effectively direct BMSCs differentiation into osteoblasts and adipocytes, thus providing a new approach for detection of the fate decision of BMSCs in vitro, especially in the case of regulating the skewed differentiation of BMSCs upon drugs stimulation.Research highlights▸A mixed differentiation medium is prepared for both osteogenic and adipogenic lineage commitment of BMSCs in vitro.▸A specifically simple but effective and low-cost method is established to simultaneously analyse the efficiency of osteogenesis and adipogenesis of BMSCs.