〔Abstract〕 Objective To explore the influence of alendronate sodium combined with dapagliflozin on clinical effect of patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis. Methods A total of 112 patients with T2DM and osteoporosis admitted to The People’ s Hospital of Hechi from June 2020 to June 2022 were selected as the study subjects and were randomly divided into a control group and an observation group, with 56 cases in each group. The control group was treated with alendronate sodium combined with metformin, and the observation group was given alendronate sodium combined with dapagliflozin. Fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, bone mineral density, bone metabolism indicators [serum 25-hydroxyvitamin D (25-OH-VD), total procollagen type 1 intact N-terminal propeptide (T-PINP), β-C-terminal telopeptide of type I collagen (β-CTX)], blood calcium and blood phosphorus before and after treatment and occurrence of adverse reactions during treatment were compared between the two groups of patients. Results After treatment, the levels of fasting blood glucose, 2 hours postprandial blood glucose and glycated hemoglobin in the two groups were lower than those before treatment, with statistical significance (P < 0.05); However, there was no significant difference between the two groups (P > 0.05). After treatment, the levels of density of lumbar spine (L1-L4), total hip and femoral neck in the two groups were higher than those before treatment, and the differences were statistically significant (P < 0.05); However, there was no significant difference between the two groups (P > 0.05).After treatment, the levels of serum T-PIPN and β-CTX in the two groups were lower than those before treatment, the differences were statistically significant (P < 0.05); However, there was no significant difference between the two groups (P > 0.05). After treatment, the serum 25-OH-VD level between the two groups was significantly higher than that before treatment (P < 0.05); However, there was no significant difference between the two groups (P > 0.05). After treatment, the levels of blood calcium and blood phosphorus in the two groups were compared with those before treatment and were compared between the two groups, and there was no statistical significance (P > 0.05). During treatment, there was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Alendronate sodium combined with dapagliflozin can help control blood glucose and osteoporosis and improve the bone metabolism indicators in the treatment of patients with T2DM and osteoporosis, and the combined drug has good safety.