Low bone mass is frequently encountered than expected in the Mediterranean and Gulf countries, which are sunny most of the time. As Kuwait is one of these sunny countries, we aimed to investigate the effect of outfitting style on bone mineral density (BMD) and on markers of bone turnover in middle-aged pre-menopausal Kuwaiti women. Two groups of pre-menopausal single Kuwaiti females (20-35 yrs of age; 20 per study) were recruited. Written informed consent was obtained from each subject. A questionnaire was filled in by all subjects to obtain history and anthropometric data. Group I (GI) included females wearing black veil since puberty and not exposed to the sun. Group II (GII) included females wearing western clothes. Fasting blood samples were collected for measurement of baseline biochemistry, minerals, and markers of bone turnover (osteocalcin, N-telopeptide of type I collagen [sPINP] and C-telepeptide of type I collagen [sICTP]). BMD was measured by dual energy x-ray absortiometry (DEXA) at the lumbar spine, femoral neck and total body. Statistical analysis was performed using SPSS 15. The two subjects were matched for age mean±SEM (GI versus GII) (22.5 ± 0.48 vs. 22.3 ± 0.49). The mean total body BMD of the two groups were similar (BMD1.16 ± 0.02 vs. 1.13 ± 0.015 g/cm2), T-score of total body (0.405 ±0.25 vs. 0.050±0.19). However, BMD of L2-L4 spine was significantly lower in veiled (GI) compared with non-veiled (GII) females (T-score of L2-L4: -1.294 ± 0.33 vs. -0.06 ± 0.24, p<0.01). As for bone markers, sPINP and sICTP were significantly raised in veiled (GI) compared with non-veiled (GII) (p<0.01 and p<0.002, respectively). Bone mineral density is decreased in young pre-menopausal Kuwaiti females wearing veils compared with those without veils. They have evidence of raised bone turnover as shown by the elevation of markers of bone formation and resorption. It is therefore essential to assess vitamin D status in both groups to verify its link with the partial difference in sun exposure.