People with learning disabilities are at increased risk of low bone mineral density, osteopenia, osteoporosis and fractures, compared to the general population, mainly due to higher levels of obesity or undernutrition, reduced weight-bearing exercise, and polypharmacy, including anti-epileptic and antipsychotic medications. Healthy lifestyles that reduce obesity and ensure adequate levels of vitamin D, calcium, protein, and a variety of vegetables, can protect people from developing musculoskeletal diseases and support bone health. Families, carers, and service users are seeking advice increasingly on the use of supplements that target bone health. This article reviews the evidence on bone health in people with learning disabilities, and examines the benefits of vitamin supplements and dietary approaches. It also makes some recommendations for practice.