Objective:To investigate the prevalence of the postmenopausal women with osteoporosis in Suzhou urban area and evaluate the relationship between MTHFR gene (677C>T and 1298A>C) polymorphisms and the susceptibility to osteoporosis in postmenopausal Suzhou women. Methods:A population-based case-control study was conducted,including 261 postmenopausal women aged from 45 to 70 years enrolled through randomized cluster sampling in the community of Suzhou city. The research subject registered their basic information such as height,weight,waist circumference,hip circumference. Bone mineral density was measured by radius quantitative ultrasound. The polymorphisms of MTHFR genes were detected using the TaqMan real-time polymerase chain reaction(PCR) method. Results:Compared with the control group(34.02%),the frequency of the MTHFR 677T allele was significantly increased in osteoporosis group (43.48%),P = 0.039. Concerning the incidence of postmenopausal osteoporosis,the TT genotype had more than twice of the risk of the CC and CT genotype (OR=2.37,95%CI=1.15~4.87),especially in women aged≤60 years and central obesity(waist to hip ratio≥0.80). No association was observed between the MTHFR 1298A>C polymorphism and postmenopausal osteoporosis (P = 0.787). Conclusion:The MTHFR 677C>T polymorphism may contribute to the susceptibility of osteoporosis in postmenopausal women in Suzhou city.