Osteoporosis and obesity are highly prevalent chronic conditions that pose major health challenges worldwide. While both are traditionally viewed through distinct clinical lenses, their coexistence is increasingly recognized as an important issue in primary care, where early screening and comprehensive risk management are critical. Understanding how these conditions interact to influence long-term mortality may help improve preventive strategies in aging populationsTo examine the combined effects of osteoporosis and obesity on all-cause and cardiovascular mortality in a nationally representative Korean population, emphasizing implications for integrated primary care management.Data were drawn from the Korea National Health and Nutrition Examination Survey (2007–2012) linked with national mortality records through 2019. Adults aged ≥50 years who underwent dual-energy X-ray absorptiometry (DEXA) were included (n≈21,300). Osteoporosis was defined as a T-score ≤ −2.5, and obesity was defined by DEXA-measured body fat percentage. Participants were categorized into four groups according to osteoporosis and obesity status (G+O+, G+O−, G−O+, G−O−). Cox proportional hazards models were applied to estimate hazard ratios for all-cause and cardiovascular mortality after adjustment for demographic, behavioral, and clinical factors.Over a median follow-up of 8.2 years, approximately 2,100 deaths occurred, including 600 cardiovascular deaths. Preliminary analyses suggest that osteoporosis independently increases mortality risk and may amplify adverse outcomes when combined with obesity. Full analyses will be presented at the conference.These findings underscore the need for a holistic approach to managing patients with osteoporosis and obesity in primary care. Lifestyle counseling, fall prevention, and cardiovascular risk control should be integrated to address overlapping metabolic and skeletal risks.The coexistence of osteoporosis and obesity may be a key determinant of long-term survival among older adults. Proactive screening and multidisciplinary management strategies in primary care can improve outcomes for this growing patient population.