Bone is essential for supporting muscles and protecting vital organs, as well as serving as a reservoir for calcium and phosphorus. As one of the most metabolically active tissues in the body, bone undergoes constant remodeling to meet the demands of health. Adequate oxygen is required to maintain the physiological functions of bone cells, as evidence suggests that hypoxia may affect bone health. The relationship between hypoxia and osteoporosis has become a recent hot topic in research. Hypoxia plays a critical role in various aspects of bone tissue, including cell proliferation, differentiation, apoptosis, and maintenance of stability, and is deeply involved in bone remodeling. This article reviews the existing reports on the relationship between hypoxia and bone homeostasis, as well as osteoporosis, with the aim of providing a reference for future prevention and treatment of osteoporosis.