OBJECTIVE To evaluate the diagnostic value of quantitative ultrasound test (QUS) in osteoporosis screening by comparing stiffness index (STI) calculated by QUS and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in Chinese community population. METHODS A total of 6 105 residents aged 45 years and over from Shanghai Changfeng community were recruited. BMD of lumbar spine (L1-L4) and both femur measured by DXA and calcaneus STI calculated by QUS were observed simultaneously in the same day. The sensitivity, specificity and accuracy of QUS and DXA (gold standard) on the diagnosis of osteoporosis were compared. RESULTS The prevalence of osteopenia or osteoporosis diagnosed by DXA and QUS was 38.82%, 10.29% and 64.50%, 4.49% respectively. STI was correlated with BMD of spine, left and right femur, respectively with the correlation coefficients of 0.536, 0.574 and 0.570 (all P < 0.001). The sensitivity and specificity of QUS for osteopenia was 86.16% and 47.57% and for osteoporosis was 23.57% and 97.70%. CONCLUSION STI calculated by QUS had a good correlation with BMD measured by DXA. The high sensitivity and specificity of QUS made it as a diagnostic tool for osteopenia and osteoporosis screening in community health care center.