Background: Osteoporosis considered as the most common metabolic bone disorder which is common in menopausal women. Improving knowledge and self-efficacy about osteoporosis among menopausal women. Aim: To evaluate the effect of educational guidelines on improving knowledge and self-efficacy for menopausal women with osteoporosis. Subjects and methods: At the bone density measurement unit at Zagazig University hospitals, A quasi-experimental design, including pre-, and post-test, was used. A purposive sample composed of Seventy-five menopausal women. Tools: An interview questionnaire sheet and The Osteoporosis Self-Efficacy Scale were used. An interview questionnaire sheet consisted of (demographic characteristics, medical and family history, knowledge of osteoporosis). Results: 66.7% of married participants (4.7%) with age 52.40 ± 1.21 had totally unsatisfactory level of knowledge regarding osteoporosis at pre-intervention, while 82.7% of them had a satisfactory knowledge of post intervention at p value .000. only 18.7% of the women had strong levels of their total self-efficacy towards osteoporosis at pre-intervention, where changed to 52.0% at post intervention. There was a very strong link between how many women knew about osteoporosis and how confident they felt about what they knew (P≤ 0.01) before and after talking about the educational sessions. Conclusions: the applying of educational guidelines for menopausal women suffering from osteoporosis affected in improving their knowledge, and self-efficacy regarding osteoporosis. Recommendations: For greater improvements, more established interventions and programs should be implemented in the research context.