The assessment of interactions between SCL and OPG/RANK-L system in acromegaly continues to be challenging due to many factors influencing levels of SCL, OPG, and RANK-L, however, it is worth noting that a more detailed understanding of the pathomechanism of bone complications in acromegaly may contribute to better diagnostic and therapeutic management and improvement of the quality of life in acromegaly patients. The gene discussed is TNFSF11; the disease is acromegaly.