Objective：To investigate the effect of Fracture Risk Assessment Tool（FRAX） combined with dual-energy X-ray absorp－tiometry（DXA） in predicting fractures in patients with osteoporosis. Methods：A retrospective analysis was performed for the clinical data of 3 000 patients with osteoporosis who were admitted to our hospital from January 2016 to January 2019，and all patients under－went FRAX assessment and DXA examination. The risk of fractures determined by FRAX was compared between male and female patients. Bone mineral density（BMD） in the anterior，posterior，and lateral positions of L2-4，detection rate of fractures in the anterior，posterior，and lateral positions of L2-4，and outcomes of fractures at different sites were recorded for patients in different ages. Results：There was no significant difference in the risk of hip fracture determined by FRAX between male and female patients（P>0.05），and female patients had higher risk of fractures at each site than male patients（P<0.01）. Among the 3 000 patients with an－terior and posterior BMD measurements，529 patients had a T value of >-1.0 s，1 426 patients had a T value of ≤-1.0 s and >-2.0 s，572 patients had a T value of ≤-2.0 s and >-2.5 s，and 455 patients had a T value of ≤-2.5 s. Among the 3 000 pa－tients with lateral BMD measurements，424 patients had a T value of >-1.0 s，717 patients had a T value of ≤-1.0 s and >-2.0 s，808 patients had a T value of ≤-2.0 s and >-2.5 s，and 1 181 patients had a T value of ≤-2.5 s. The detection rates of fractures at the anterior and posterior positions of L2-4 were 34.80%（T value≤-2.0 s） and 15.60%（T value≤-2.5 s），respectively，and the detection rates of fractures at the lateral position were 57.60%（T value ≤-2.0 s） and 39.37%（T value≤-2.5 s），respectively. Of all 3 000 patients，348 had spinal fractures，622 had hip fractures，1 154 had wrist fractures，and 876 had femoral neck fractures，and there were no significant differences in the T val－ues of the anterior/posterior and lateral positions between the patients with fractures at different sites（P>0.05）. Conclusion：FRAX has a good effect in evaluating fractures in patients with osteoporosis，with a better effect in female patients than in male pa－tients. DXA has a good predictive effect in patients with osteoporosis，and a T value of ≤-2.0 s can be used as a standard value for the prediction of fracture.