Strontium ranelate has been introduced recently for the prevention and treatment of osteoporosis in Europe and in many countries worldwide. This article reviews the published cost-effectiveness literature pertaining to strontium ranelate. Six studies were identified: two in the UK, two in Belgium and two in Sweden. The findings were consistent across the literature, suggesting that strontium ranelate is a cost-saving drug for women with osteoporosis aged over 80 years, and it is a cost-effective treatment compared with no treatment for osteoporotic women aged over 70 years and for younger women with clinical risk factors for fragility fracture. Strontium ranelate was also shown to be cost effective compared with branded risedronate in osteoporotic women aged over 75 years. Further analyses are required to assess the effectiveness and adherence to strontium ranelate in real-life settings, as well as to evaluate the cost-effectiveness of strontium ranelate in other countries and in populations of men.