Objectives: This study investigated the relationship of head lean mass to bone mineral density (BMD). Method: Subjects were 102 elderly women (greater than or equal to 65-years-old) and 123 middle-aged postmenopausal women (< 65-years-old) with right-side dominance. Age, height, weight, and years since menopause (YSM) were recorded. Lean mass of the head, arm, trunk, leg, and total body were measured by dual-energy X-ray absorptiometry (DEXA). BMD of the same regions were measured by DEXA. Results: In elderly women, head lean mass was positively correlated with BMD of the head (r = 0.389, P < 0.01), left arm (r = 0.235, P < 0.05), right arm (r = 0.280, P < 0.05), lumbar spine (L2-4) (r = 0.411, P < 0.001), pelvis (r = 0.490, P < 0.001), left leg (r = 0.572, P < 0.001), right leg (r = 0.558, P < 0.001), and total body (r = 0.529, P < 0.001). These relationships remained significant after adjusting for age, height, and YSM In addition, the strength of correlation of head lean mass with BMD was higher than those of other regional lean mass with respective BMD. In middle-aged women, strength of correlation of head lean mass with BMD was loose (r less than or equal to 0.238), while regional lean mass was more correlated with respective regional BMD. Conclusion: Factors related to lifestyle associated with higher (lower) head lean mass may contribute to higher (lower) BMD in elderly postmenopausal women. (C) 2003 Elsevier Ireland Ltd. All rights reserved.