Abstract: Objective To understand the self-efficacy and health behaviors with respect to osteoporosis of middle-aged and elderly subjects living in the communities. Method A questionnaire-based survey was conducted using the Osteoporosis Self-Efficacy Scale (designed by Horan M et al) and osteoporosis health behaviors questionnaire designed by the authors among 290 middle-aged and elderly community dwellers.Results The mean score of the self-efficacy was 64.75±21.93 among the involved subjects without statistically significant difference in terms of gender and intensity of daily exercises. The score differed significantly, however, in terms of age, education background, occupation and calcium intake (P<0.01), and the older group had lower scores than the younger one. Subjects with higher education scored higher, and those with occupations of physical labor scored lower than those with intellectual work. Higher calcium intake also resulted in higher score. It was found in this survey that the preventive behaviors of osteoporosis was insufficient among the subjects, and only 36.1% of the subjects drank milk everyday with 29.2% often having bean products and 49.8% taking calcium supplements. A percentage of 58.1% of these subjects regularly took part in exercises more than 3 times a week for over 30 minutes each time, but they seldom took weight bearing exercise.Conclusion Osteoporosis self-efficacy should enhanced to promote osteoporosis- preventing behaviors in osteoporosis education program for the middle-aged and elderly people in the communities.