In order to reduce the risk of development of osteoporotic fragility fractures by identification of individuals carrying highest risk factors , we selected 50 perimenopausal women of 40 to 55 years age who attended in orthopaedic OPD in SSKM Hospital, Kolkata, West Bengal, India from September 2019 to November2019 with skeletal pain. The structured interview schedule was administered to collect the demographic information as well as to assess their knowledge on osteoporosis and related fractures. Then the physical examination proforma was used to assess the height, weight & BMI of the participants. The descriptive survey design was used with demographic and research variables. The nonprobability purposive samples were selected as per inclusion and exclusion criteria. In our study, there is significant knowledge deficit among perimenopausal women regarding osteoporosis and resultant fragility fractures irrespective of age and occupation, but associated with lack of conventional education. Significant knowledge deficit (SKD) in 31 patients (62%) of our samples proves reformation & improvement of education in multiple ways is urgently needed for definite increase of the knowledge. High priority group has been identified in this significant knowledge deficit (SKD) group, carrying high risk of occurring fragility fracture who need urgent attention. 11 patients (22%) had SKD with osteoporosis (BMD as per DEXA more than – 2.5) and abnormal BMI were termed as highest priority group who needed urgent requirement of comprehensive management of osteoporosis. 13 patients who had SKD with osteopenia (BMD as per DEXA between – 1 to -2.5) and abnormal BMI were termed as moderately priority group who carry relative urgency of treatment. Whereas seven patients who had SKD with normal BMI and osteopenia or normal BMD were termed as low priority group who may be kept under observation prior to initiation of comprehensive management of osteoporosis.