Background: Osteoporosis is a decrease in bone mass and worsening of bone tissue, which causes a decrease in bone density or porous bones. Muscle strengthening exercise is a voluntary exercise to increase skeletal muscles strength, power, endurance, and mass that includes the use of weight machines, hand-held weight, exercise band, or own body weight. People do strengthening exercise for many purposes, including aesthetic, physical therapy, sports, conditioning for sports performance, and general fitness and health. This literature review aims to review the effect of strengthening exercise in postmenopausal osteoporosis focusing on the bone density and the risk of falling. Methods: This study is a literature review which assembled by searching, compiling, and analyzing various studies that focused on the effect of strengthening exercise in postmenopausal osteoporosis. Results: For the bone density, the osteogenic effect in increasing bone mass can be stimulated by means of bone tissue being exposed to mechanical loads that exceed what is experienced during daily activities. For the risk of falling, the special population such as osteoporotic women and/or osteoporotic postmenopausal women, overall, the general idea of falling risk results in older adults can be decreased with exercises and/or exercises programs. Conclusion: strengthening exercise can increase the bone density and reduce the risk of falling, hence postmenopausal women whose at risk of osteoporosis should receive strengthening exercise in accordance with the recommendation to prevent worsening of the disease and complications.