Anti-osteoporosis alkaloids are classified into six categories: they promote mesenchymal stem cell differentiation, improve osteoblast proliferation, stimulate osteoblast autophagy, suppress osteoclast formation, regulate multiple signaling pathways, including interrupting the tumor necrosis factor receptor-associated factor 6- receptor activator of NF-κB interaction, inhibiting the NF-κB pathway in osteoclasts, activating the p38 mitogen-activated protein kinases pathway in osteoblasts, and triggering the wingless and int-1 pathway in mesenchymal stem cells. Here, NFKB1 is linked to osteoporosis.