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Dokuz Eylul University, School of Medicine, Department of Radiology, Inciralti, Turkey DOI : 10.5137/1019-5149.JTN.10244-14.0 Bilateral pedicle fracture is an extremely rare entity and few cases have been reported in literature. A case of bilateral multi-level pedicle fractures involving four lumbar vertebrae is being presented. Bilateral pedicle stress fracture at L1 - L4 was observed in a 61-year-old woman presented with low back pain. There was no any predisposing factor like trauma, spinal surgery, smoking or alcohol consumption except mild osteoporosis and bisphosphonate usage in the patient’s medical history. We are unable to determine whether the fractures are related to osteoporosis or bisphosphonate therapy but these are the only remaining suspected reasons in the present case. Further studies are required to define the effect of bisphosphonates usage on vertebral segments. Keywords : Bilateral pedicle fractures, Multi-level, Osteoporosis, Bisphosphonates usage