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Objective To explore the prevalence of osteoporosis in adult women in Inner Mongolia Autonomous Region and to analyze the influencing factors. Methods Totally 1 333 adult women from 4 regions of Inner Mongolia were selected by stratified cluster random sampling method from July 2014 to December 2015. Questionnaire survey, physical examination and laboratory testing were conducted. Calcaneal bone mineral density was measured by dry ultrasound bone mineral density analyzer. Univariate and multivariate Logistic regression were used to analyze the influencing factors of osteoporosis in adult women. Results The prevalence of osteoporosis in adult women in Inner Mongolia was 7.88% (standardized rate 8.56%). Logistic regression analysis showed that the protective factors of osteoporosis prevalence included young age, high intensity of physical exercise and high height (P＜0.05), while menopause was an independent risk factor for osteoporosis (P＜0.05). Conclusions The osteoporosis of adult women in Inner Mongolia is closely related to age, physical exercise, menopause and body height.