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Introduction-Carcinoma prostate (CaP) patients with skeletal metastases, on ADT and co-existing osteoporosis have more bone events. In this study we evaluate the bone health kinetics in the management of CaP patients. Material and methods - A prospective observational study was performed in 101 consecutive patients of CaP (on ADT or hormone naïve). The bone density was measured with DEXA Scan at lumbar spine, left/right femur neck at 1st visit, 3rd and 6th month. Patients with negative T-Score were started on zolendronic acid (Z) or denosumab (D). Results- Forty seven patients were started on Z, out of them, 27 (57.5 %) were significantly improved and showed positive change in BMD with improvement in T-score (p < 0.05). Five patients with borderline renal function at 3rd month were shifted to D. Also, 15 patients did not improve at 3rd month and they were shifted to D. Out of these 20 patients on D, 16 patients showed improvement in BMD though p value was not significant. Thirty nine patients were given D as initial treatment modality and showed significant improvement (p < 0.05). Out of the 15 patients who had high baseline BMD, 11 showed positive change (p value not significant) with calcium and vitamin D supplementation only at 3 and 6 month BMD measurements. Four patients were started on Z at 3rd month. Conclusion - There is a need to sensitize urologists regarding bone health kinetics and early preventive or curative measures. Thus in turn prevent fractures and other skeletal related events in this group of population. [ABSTRACT FROM AUTHOR]