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Aim: Previous studies have reported inconsistent findings regarding the associations between homocysteine (Hcy), vitamin B12, folate, and bone mineral density (BMD) in postmenopausal women.We investigated the associations between homocysteine, vitamin B12, folate, and bone mineral density in postmenopausal women by conducting a meta-analysis and systematic review.Methods: We searched for all published articles indexed in MEDLINE (1950-2012), EMBASE (1974-2012), and the China National Knowledge Infrastructure (CNKI, 1994 2012).Any observational studies that were related to plasma homoeysteine, vitamin B12, folate and osteoporosis were included, and the data were extracted independently.by two reviewers.Criteria for inclusion were the assessment of Hey, vitamin B 12, folate, and BMD in postmenopausal women as outcomes.The electronic literature searches yielded 713 potentially relevant articles, from which 6 studies met the inclusion criteria.We performed this meta-analysis with Review Manager 5.1 software.Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the results.Results: These six studies with 288 osteoporosis cases and 361 controls suggested that serum vitamin B12 levels were statistically significantly higher in the postmenopausal osteoporosis (PMOP) group than in controls (P=0.007, <0.05;95%CI 3.06-19.38).Similarly, serum Hcy levels were statistically significantly higher in the PMOP group than in controls (P=0.0003, <0.05; 95%CI 0.75-2.52).However, serum folate levels were lower in the PMOP group than in controls, but this difference was not statistically significant (Z=1.69, P=0.09, >0.05; 95% C1-3.33-0.25).Conclusions: This meta-analysis and systematic review suggested that serum Hcy and vitamin B12 levels, but not folate levels, were associated with postmenopausal osteoporosis.