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Aim: The study aimed to investigate the link between dietary copper, iron, zinc, selenium intake with osteopenia and osteoporosis in elderly hypertensive patients., Methods: The data of hypertensive patients were extracted from the National Health and Nutrition Examination Survey 2005-2010, 2013-2014, and 2017-2018. Data of dietary iron, zinc, copper and selenium intakes were obtained according to 24-h diet recall interviews. Osteopenia and osteoporosis were determined based on the bone mineral density. Weighted liner regression and weighted logistic regression were employed to assess the association between iron, zinc, copper, and selenium intakes with osteopenia and osteoporosis. All results were presented as β, odds ratios (ORs), and 95% confidence intervals (CIs)., Results: In total, 5,286 elderly hypertensive patients were included. Among them, 2,961 (56.02%) patients have osteopenia, and 566 (10.71%) have osteoporosis. After adjusting all covariates, dietary copper intake ≥the recommended daily allowance was positively correlated with bone mineral density on total femur (β = 0.086, 95% CI: 0.021-0.152) and femoral neck (β = 0.097, 95% CI: 0.016-0.178). Dietary zinc intake ≥the recommended daily allowance was also positively correlated with bone mineral density on total femur (β = 0.092, 95% CI: 0.030-0.153) and femoral neck (β = 0.122, 95% CI: 0.050-0.193). Dietary copper (O = 0.581, 95% CI: 0.394-0.858) and zinc (OR = 0.595, 95% CI: 0.429-0.827) intake ≥the recommended daily allowance levels were related to increased odds of osteoporosis in elderly with hypertension., Conclusion: Higher dietary copper and zinc intake was associated with lower odds of osteoporosis in the elderly hypertensive patients. Higher dietary intake included copper and zinc may be beneficial for the bone health in the elderly hypertensive patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Jia and Gao.)