Hypoparathyroidism is a rare disorder characterized by hypocalcemia and deficient or absent levels of parathyroid hormone. The consequences of chronic hypoparathyroidism involve classic target organs of parathyroid hormone, namely the skeleton and the kidneys. In this article, we focus on the abnormalities in bone quality that are associated with hypoparathyroidism. As assessed by several modalities, bone quality is compromised. The evidence for abnormal bone quality includes findings from bone histomorphometry, bone material properties, and high-resolution peripheral computed tomography. These abnormalities include low bone turnover, altered skeletal microarchitecture and bone material properties. How these abnormalities relate to fracture risk are under investigation. In this study, we also reviewed the therapeutic effects of parathyroid hormone as replacement therapy in this disease.