Non-steroidal anti-inflammatory drugs are powerful and effective anti-inflammatory, analgesic and anti-pyretic drugs. They are routinely used in orthopaedic conditions and in the perioperative setting. They are however associated with potentially life-threatening side-effects and it is important to appreciate these before these medicines are administered. There is evidence suggesting that these drugs adversely affect bone formation, and this has implications for their use in patients with fractures and other pathologies that involve bone remodelling.