Pregnancy- and lactation-associated osteoporosis is an uncommon condition that may be a consequence of preexisting low bone density, loss of bone mineral content during pregnancy, and increased bone turnover.To present a case of severe osteoporosis associated with pregnancy and lactation and its treatment protocol.A tertiary care hospital.A young female after twin pregnancy presenting with severe osteoporosis.The diagnosis was done on the basis of bone mineral density (BMD) measurement. The patient was treated with first alendronate and then strontium ranelate. She was considered as a candidate for kyphoplasty.A dramatic increase in the BMD and palliation of back pain were observed.Strontium ranelate may be a new alternative in the treatment of pregnancy- and lactation-associated osteoporosis.