Osteoporosis is recognized as primary or secondary related to various factors. Herein we presented a patient who developed osteoporosis and compression fractures related to high dose steroid treatment. Sixty-three years old female patient attended to our outpatient clinic with complaints of back and low back pain, and she had a history of high dose steroids for the treatment of pemphigus vulgaris. She had multiple compression fractures of the thoracic vertebrae. Bone mineral density revealed a T score of -2.3 for lumbar and -1.6 for femoral neck regions. Upon examination compression fractures were considered to be related to high dose glucocorticoid treatment. As a consequence; osteoporosis should not be overlooked in established and high dose corticosteroid treatment particularly in postmenopausal female and patients should be screened for osteoporosis prior to treatment and prophylaxis should be maintained if necessary. ©2007, Fırat University, Medical Faculty