Ibandronate is a potent nitrogen-containing bisphosphonate that is currently available as a daily and once-monthly oral formulation for the treatment and prevention of osteoporosis. It has recently been approved for intermittent intravenous administration. The oral iBandronate Osteoporosis vertebral fracture trial in North America and Europe (BONE), Monthly Oral iBandronate In LadiEs (MOBILE), and Dosing IntraVenous Administration (DIVA) trials demonstrated that long-term daily and intermittent administration of ibandronate was efficacious for increasing bone mineral density and reducing markers of bone turnover. BONE demonstrated that ibandronate reduced the risk of new vertebral fractures and reduced the relative risk of nonvertebral fractures in higher-risk patients. Histomorphometric evaluations in the BONE and DIVA trials have demonstrated that bone quality is maintained following treatment. Giving patients the option of choosing their dose regimen and route of administration may increase overall adherence to treatment, leading to enhanced fracture protection in patients with osteoporosis.