Background: Physical activity during growth and adolescence is associated with high peak bone mass, and may as a result prevent osteoporosis later in life. It is therefore possible that physical activity during youth could serve as a strategy to reduce the risk of fragility fractures at advanced ages. However, it is yet currently unclear whether former athletes actually have fewer fractures than expected with age. Purpose: This study aimed to evaluate fracture incidence in former male athletes. Methods: In a retrospective matched controlled design lifetime incidence of fractures was registered through a mailed questionnaire sent to 709 former male athletes now with a median age of 70 years (range 50-93), who had given up regular sports activity a median 35 years (range 1-63) ago, and to 1368 male controls aged a median 70 years (range 51-93). Fragility fractures were defined as factures due to a light trauma and after age 50 in proximal humerus, distal radius, vertebra, pelvis, hip, and tibial condyles. Both cohorts were normally distributed (Shapiro Wilk’s test). Data are presented as means with 95% confidence intervals (95% CI). Group differences were evaluated by Student’s t-test between means and chi-square test. Differences between athletes and controls in time to first fracture were evaluated by Kaplan-Meier survival curves, and rate ratios (RR) were estimated by Poison distribution. Results: The anthropometrics and lifestyle factors were most similar between the groups. There was no group difference in current Body Mass Index and level of leisure-time physical activity. After retirement from sports (age 35 years), the former athletes had a lower risk of sustaining any fractures with a RR of 0.70 (0.52, 0.93), a lower risk of sustaining any fragility fractures (RR 0.50 (0.27, 0.89)), and a lower risk of sustaining a distal radius fracture (RR 0.29 (0.09, 0.74)), but did not reach statistical significance as regard to hip fracture after age 50 (RR 0.79 (0.28, 2.00)) (Figure 1). Conclusions: Intense physical activity during growth and young adulthood is in retired sportsmen associated with a lower risk of sustaining a fracture than expected by age. In a wider perspective, this indicates that physical activity in younger years could be recommended as a feasible strategy to reduce the incidence of fragility fractures in older ages.