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Objective To evaluate the applicability of fracture risk prediction tool FRAX in the population in Xinjiang, and to investigate the effect of FRAX on fracture prediction with or without the availability of bone mineral density (BMD) of the femoral neck in different nationalities. Methods A total of 103 patients (63 were Han and 40 were Uygur) with osteoporotic fractures, who were treated in our hospital from July 2012 to June 2013, were selected. The clinical data of all the patients were retrospectively analyzed. All the risk factors contained in FRAX prediction tool were collected. The data including BMD of the femoral neck were input into the FRAX prediction tool. Then, the fracture probability of main parts (the hip, the spine, the humerus, and the wrist) and the hip in the next 10 years was calculated. With the consideration of different nationalities and with or without BMD of the femoral neck, the FRAX results were compared. Results In all 103 patients with osteoporotic fractures, without BMD in the tool, the fracture probability of main parts and the hip in the next 10 years was 0. 9% - 14% and 0% - 5.2%, respectively. When with BMD in the tool, the fracture probability of main parts and the hip in the next 10 years was 1. 2% - 26% and 0% - 17%, respectively. And no significant difference of the fracture probability was observed with or without BMD (P > 0. 05). Considering different nationalities, with the Han nationality in the tool, the fracture probability of main parts and the hip in the next 10 years was 1% - 26% and 0% - 17%, respectively. As for Uighur, the probability was 0. 9% - 7% and 0% - 3.4%, respectively. And the difference of the fracture probability of main parts and the hip between Han and Uygur was significant (P < 0. 01). Conclusion FRAX fracture risk prediction tool can be used in the population in Xinjiang. Without BMD, the FRAX predicted results are also reliable. The accuracy of FRAX fracture risk prediction in Uighur population may be lower than that in Han population. [ABSTRACT FROM AUTHOR]