Atypical femoral fracture (AFF) is a rare yet potentially devastating complication associated with long-term antiresorptive therapy for osteoporosis. Given the substantial differences between Asian and Western populations in femoral anatomy, genetic background, and patterns of anti-osteoporotic medication use, the Asia Federation of Osteoporosis Societies (AFOS) officially released the AFOS 2025 Consensus on “Atypical Femoral Fracture in Patients with Osteoporosis”, based on multinational expert surveys and the latest available evidence. This consensus provides region-specific recommendations tailored to Asian populations, focusing on key aspects of AFF management, including early recognition and imaging surveillance, risk-stratified intervention for incomplete fractures, surgical fixation strategies for complete fractures, and individualized sequential anti-osteoporotic therapy after surgery. The present article offers an in-depth interpretation of the core principles and clinical implications of this consensus, with the aim of assisting Chinese clinicians in more precisely balancing the long-term benefits and risks of anti-osteoporotic treatment, and in providing an advanced reference for systematically optimizing the prevention and management of AFF.