Objective To investigate the correlation between serum Gremlin-1, dpucMGP and osteoporosis in elderly men. Methods A total of 139 elderly male patients with osteoporosis diagnosed in our hospital from January 2019 to December 2020 were selected as the case group, and 142 healthy male patients in our hospital during the same period were included as the control group. Serum Levels of Gremlin-1, DP-ucMGP and bone metabolism were determined by enzyme-linked immunosorbent assay. ROC curve was used to analyze the clinical value of serum Levels of Gremlin-1 and DP-ucMGP in the diagnosis of osteoporosis.Results The ALB, HDLC, LDLC, TC, TG, TP, age, systolic blood pressure, diastolic blood pressure, BMI and other basic data was no significant difference between the control group and the case group (P＞0.05). The serum levels of Gremlin-1 and dp-ucMGP in the case group were significantly lower than those in the control group (P＜0.05). The serum PINP and β-CTX levels of the case group were significantly higher than those of the control group, and the serum 25 (OH)D, N-MID, OC and BMD levels were significantly lower than those of the control group (P＜0.05). Gremlin-1 and dp-ucMGP were negatively correlated with PINP and β-CTX, and positively correlated with 25(OH)D, N-MID, OC and BMD (P＜0.05). The receiver operating characteristic curve showed that the area under the ROC curve of Gremlin-1 and dp-ucMGP predicting osteoporosis in elderly men was 0.859 (95%CI: 0.768~0.943), 0.833 (95%CI: 0.748~0.924), and the sensitivity and specificity of both indexes for the diagnosis of osteoporosis were similar (x2=1.563, 1.215, P＞0.05). Multivariate logistic regression analysis showed that low Gremlin-1, low dp-ucMGP, low 25(OH)D, and high β-CTX were risk factors for osteoporosis in elderly men ［OR and 95%CI: 2.18 (1.17～4.08), 4.14 (1.58～10.81), 5.62 (2..06～10.32), 3.06 (1.54～6.08)］. Conclusion The serum Gremlin-1 and dp-ucMGP of osteoporosis patients are decreased, and Gremlin-1 and dp-ucMGP are closely related to bone metabolism indexes. The decrease of Gremlin-1 and dp-ucMGP are risk factors for osteoporosis in elderly men.