Under the transcriptional control of numerous factors and intracellular signals, mesenchymal stem cells (MSCs) can differentiate into various cell types, including adipocytes and osteoblasts. However, the precise cellular signaling factors that determine the cell fate of MSCs in bone marrow remain largely unknown. In this review, we focus on the ties of PPAR-γ and Wnt signaling in MSC differentiation into adipocytes and osteoblasts. Peroxisome proliferator-activated receptor-γ (PPAR-γ) is well established as a prime inducer of adipogenesis, while the Wnt pathway is regarded as the master moderator of osteogenesis. A theoretical inverse relationship exists between adipogenic and osteogenic lineage commitment and differentiation: the differentiation toward an osteoblast phenotype occurs at the expense of an adipocyte phenotype. It has been proposed that the balance between osteogenic and adipogeneic MSC differentiation is disrupted in diverse areas of human health. Therefore, understanding the ties between PPAR- γand Wnt signaling in MSC differentiation has significant implications in diverse areas of human health, from obesity to osteoporosis to regenerative medicine.