Osteoporosis is a major cause of morbidity in older people. There are a large number of risk factors for the development of senile osteoporosis. However, recent discoveries suggest that these risk factors could exert their effects through immunologically mediated modulation of bone remodelling. Inflamm-ageing itself plays a role in bone remodelling through pro-inflammatory cytokines, which are known to influence osteoclasts and osteoblasts, together with other more recently discovered immunological mediators and transcription factors. Senile osteoporosis is an example of the central role of immune-mediated inflammation in determining bone resorption. In this review, we will discuss the pathogenesis of osteoporosis in the context of immunosenescence.