Denosumab is indicated for the treatment of osteoporosis in postmenopausal women and men at high risk of fractures, as well as for prevention of skeletal-related events in patients with bone metastases from solid tumors. It works by targeting RANKL, a key mediator of osteoclast formation, thereby inhibiting bone resorption and increasing bone strength. Its main advantage is potent and sustained antiresorptive effect with convenient dosing (once every 6 months for osteoporosis), improving patient adherence. Unlike bisphosphonates, it is not renally cleared, making it suitable for patients with renal impairment. In oncology, denosumab effectively reduces the risk of fractures, spinal cord compression, and need for radiation or surgery to bone. Its targeted mechanism, strong efficacy, and convenient administration make it a highly valuable option in both osteoporosis and oncology practice.