Objective With the increasing clinical application of biologics in osteoporosis treatment, challenges such as insufficient evidence for rational drug use and a lack of evidence-based guidance have emerged in clinical practice. To address these issues, the Committee of Evidence-Based Pharmacy of Chinese Pharmaceutical Association, the Pharmaceutical Specialized Committee of Chinese Hospital Association and the Committee of Osteoporosis of Beijing Research Association for Chronic Diseases Control and Health Education jointly developed the medication therapy of biological agents in osteoporosis: an evidence-based practice guideline (2025). It aims to standardize the medication therapy of osteoporosis biologics (Denosumab and Teriparatide). Methods The design, planning, development process, and reporting of this guideline adhered to international methodological standards, such as the WHO handbook for guideline development. We integrated the three core principles of evidence-based medicine: systematic evidence analysis using evidence-based pharmacy methods, evidence quality assessment via the GRADE framework, incorporation of patient preferences through surveys, and consolidation of multidisciplinary expert clinical experience via the Delphi method. This guideline was registered on the International Practice Guidelines Registry Platform (Registration No. IPGRP-2022CN386), with development initiated in July 2022 and finalized in October 2025. Results This guideline established a decision-making framework comprising 28 recommendations, covering the entire pharmaceutical care process for Denosumab and Teriparatide in osteoporosis treatment: pre-treatment assessment (9 recommendations), formulation of treatment protocol (11 recommendations), monitoring and management during treatment (6 recommendations), and sequential therapy after discontinuation (2 recommendations). Conclusion As the first clinical practice guideline for osteoporosis biologics developed based on the integration of evidence, experts’ clinical experience, and patient preferences, it proposes an innovative pharmaceutical care strategy (assessment-treatment-monitoring-sequential therapy). Multidisciplinary clinical teams may refer to this guideline to deliver pharmaceutical services and patient management throughout the pre-treatment, during-treatment, and post-treatment phases of Denosumab and Teriparatide therapy for osteoporosis patients.