Osteoporosis in men is an increasingly important clinical issue, that actually remains under-recognized and undertreated. Moreover there is no validated strategy for a systematic osteoporosis screening in men and decisions regarding treatment should be based on the absolute risk of fracture. Among the different treatment options, bisphosphonate therapy is becoming a mainstay in the treatment of male osteoporosis, even though evidence for the long-term efficacy and safety of therapies for osteoporosis in men remains limited. In this review, we report the current evidence on the use of zoledronic acid, a potent aminobisphosphonate that can be administered intravenously, for the prevention and treatment of osteoporosis in men.