The treatment and prevention of osteoporosis is crucial as fragility fractures, the clinical outcome of osteoporosis, are a common cause of bed confinement. We organized a multidisciplinary care team composed of physicians, nurses, pharmacists, physical therapists, dietitians, radiologists, and laboratory technicians in September 2020 to establish the Fracture Liaison Service (FLS) in April 2021. The attending pharmacist was dedicated to FLS, different from the one dedicated to orthopedic beds, where the pharmacist’s task is to ensure compliance with osteoporosis medication before and after admission. Alternatively, the pharmacist must propose prescriptions for osteoporosis medications according to the guidelines. In this study, we retrospectively evaluated the rate of osteoporosis medication initiation for secondary fracture prevention and the type of prescription drugs administered to patients with fragility fractures before and after FLS initiation in patients over 50 years of age admitted with proximal femur and vertebral compression fractures. Although pharmacists have been performing pharmaceutical services in wards, no drug prescriptions for osteoporosis have been proposed. The rate of osteoporosis medication initiation increased from 21.2％ to 83.3％ during the start of FLS activity. Moreover, the ratio of the continuing prescriptions not recommended by the osteoporosis guidelines decreased and that of the recommended prescriptions, such as eldecalcitol and bisphosphonate significantly increased. The study findings revealed that pharmaceutical care in FLS provided by pharmacists facilitated the initiation of osteoporosis medications according to the guidelines for secondary fracture prevention in patients with fragility fractures.