Variations in sex hormones influence bone health in men. Aging in men is associated with a decrease in testosterone (T) levels. We examined the relationship between T levels and changes in bone health status as measured by quantitative ultrasound (QUS) at the phalanges and the os calcis and by peripheral bone mineral density (pBMD) at the phalanges in healthy elderly Spanish men. We examined 162 men aged 65-88 years and assessed total serum T concentrations. Total serum T.05 for all the comparisons). All measured bone parameters were higher in the normal serum T group (p < .05). Multiple regression analysis revealed that serum T was an independent predictor of both QUS at the calcaneus and phalangeal pBMD. Our data indicate that T is an independent determinant of QUS at the os calcis and pBMD at the phalanges in elderly Spanish men.