Epidemiological studies show that there is a positive correlation between the risk of osteoporosis and the incidence of cardiovascular disease, and hypercholesterolemia plays an important role in the occurrence of osteoporosis. The increase of serum cholesterol and low density lipoprotein cholesterol can lead to the decrease of bone mineral density and the occurrence of osteoporosis. Osteoclast and osteoblast are the main bone metabolism cells to maintain bone homeostasis, and cholesterol plays an important role in bone metabolism. This review summarizes the effects of cholesterol and cholesterol-lowering drugs (statins) on the differentiation, formation and activity of osteoblast and osteoclast, thereby providing a novel strategy for the prevention and treatment of osteoporosis.