Background: Dental plaque is complex biofilm. Gingivitis is first stage of body responses towards dental plaque present in the oral cavity; it characterized by gum redness, swelling and bleeding without periodontal attachment loss. Osteoporosis occurs when new bone formation and old bone resorption are not equal. During menopause, women experience an increased rate of bone loss. Objective: The current study aimed to evaluate dental plaque and gingivitis in relation to knowledge and attitude among osteoporotic menopausal women in Baghdad, Iraq. Patients and methods: A cross sectional study was conducted on women attending Medical city teaching hospital in Baghdad city. The total sample composed of 90 menopausal women, and their age ranged from 45 to 65 years old. First (study) group consisted of 45 menopausal women with osteoporotic disease as appeared in dual energy X-ray absorptiometry (DEXA) scan. The second (control) group consisted of 45 menopausal women without osteoporosis as appeared in DEXA. Plaque and gingival indices were examined. Women's knowledge and attitude about osteoporosis, vitamin D and oral health were assessed. Results: Mean value of plaque and gingival indices were higher in study group than control with no statistical significant difference. Knowledge and attitude of studied women toward osteoporosis, vitamin D and oral health findings showed no statistical significant differences. Conclusion: Dental plaque and gingivitis are high among menopausal women with osteoporotic disease. Therefore, old women with osteoporosis need more oral health educational and preventive programs.