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Objective: The hypothesis was that the calcium and vitamin D supplementation prevents falls at the population level. Study design: The OSTPRE-FPS was a randomized populationbased open-trial with 3-year follow-up. The supplementation group (n = 1566) received daily cholecalciferol 800 IU + calcium carbonate 1000 mg, while the control group (n = 1573) received no supplementation or placebo. A randomly selected subsample of 593 subjects underwent a detailed measurement program including 25(OH)D measurements. Main outcome measure: The occurrence of falls was the primary outcome of the study. The participants in the subsample were telephoned at 4 months intervals and the rest of the trial population was interviewed by phone once a year. Results: In the entire trial population (ETP), there were 812 women with 1832 falls in the group and 833 women with 1,944 falls in the control group (risk ratio was 0.98, 95% CI 0.92-1.05, p = 0.160). The supplementation was not associated with single or multiple falls in the ETP. However, in the subsample, multiple fall incidence decreased by 30% (odds ratio [OR] 0.70, 95% CI 0.50-0.97, p = 0.034) in the supplementation group. Further, the supplementation decreased the incidence of multiple falls requiring medical attention (OR 0.72, 95% CI 0.53-0.97, p = 0.031) in the ETP. The mean compliance in the entire trial population was 78% and in the subsample 79%. Discussion: Overall, the primary analysis showed no association between calcium and vitamin D supplementation and risk of falls. However, the results of a post hoc analysis suggested that there was a decreased risk of multiple falls requiring medical attention: this finding requires confirmation. [ABSTRACT FROM AUTHOR]