The majority of treatment for osteoporosis has focused on secondary and tertiary strategies that attempt to preserve acquired adult bone mass. However, the occurrence of osteoporosis and its related physical and economic sequelae continue to escalate, resulting in devastating morbidity and mortality in later adulthood because of bone fractures. Mounting evidence continues to support primary intervention strategies that target adolescents during skeletal maturation as effective in building bone mass reserves with the power to resist the threat of osteoporotic fractures. Nurse practitioners need to exercise their expertise as primary care providers by teaching adolescents and their families the A, B, Cs of bone building with calcium, vitamin D and exercise.