The consequences of aging involve the risk of osteoporosis, leading to an impaired quality of life in the elderly patient, especially post menopausal women. Osteoporosis is the leading cause of morbidity and mortality in postmenopausal women. Aim of this study was to see mandibular bone changes in post menopausal osteoporotic patient after treatment with Zoledronic acid. 150 postmenopausal osteoporotic patients were selected and divided into two groups: first group was freshly diagnosed osteoporotic patients and second group one year after treatment with Zoledronic acid. All patients were evaluated by dual-energy X-ray absorptiometry (DXA), orthopantomograph (OPG) and radiovesiograph (RVG). Significant improvement of mandibular alveolar bone occurred in treated group measured by RVG. 83% and 84% of mandibular cortical index were eroded (C2&C3) in osteoporosis and treated osteoporosis respectively. Horizontal bone resorptions of mandibular alveolar bone were less in treated group vs non-treated group (88% and 97 %). The vertical bone resorptions were not significantly different in treated and non treated group (12% and 3%). In post menupousal osteoporotic patients, treatment with Zoledronic acid (Bisphosphonate) significantly improved mandibular alveolar bone in parameter of pixel intensity determines by RVG and cortical index by OPG. Post menopausal osteoporosis patient had eroded mandibular cortex.