Objectives: The purpose of this study is to report the clinical effectiveness and safety of herbal medicine treatment for postmenopausal osteoporosis. Methods: Researchers searched papers through 5 online databases including The Cochrane Library Central, Pubmed, China Academic Journal (CAJ), Oriental medicine Advanced Searching Integrated System (OASIS) and Korean studies Information Service System (KISS). Randomized controlled trials (RCTs) that used herbal medicine as treatment were included. Results: Twenty three studies were selected by the selection and exclusion criteria. The treatment group was treated with herbal medicine alone or with herbal medicine and conventional medicine. The control group was treated with conventional medicine. Most common evaluation index was Bone Mineral Density (BMD) followed by total efficacy rate and level of bone metabolism markers, level of sex hormones, etc. Compared with the control group, the treatment group was more effective and safer in all of 23 studies. Conclusions: Herbal treatment alone could be an effective and safe option in treating postmenopausal osteoporosis. Moreover herbal treatment with conventional medicine could improve its therapeutic effect on postmenopausal osteoporosis as well.