Utilizing anabolic osteoporosis therapies presents with challenges, including patient acceptance of injections, addressing medication safety concerns, and achieving medication access. We developed a pharmacist-run clinic to ensure the safe and effective use of these therapies. Primary endpoints were comparison of dual energy X-ray absorptiometry (DXA) T-scores and bone mineral density (BMD) values of the total hip, femoral neck, spine, and wrist at baseline, after abaloparatide therapy, and following 1 year of follow-on antiresorptive therapy. The secondary endpoint was the number of documented fractures during the evaluation period. 146 patients were referred for abaloparatide treatment. Ninety-one patients initiated treatment: average age was 66.7 (± 7.7) years, 56% had a history of osteoporotic fracture, baseline T-Scores of the femoral neck and spine were -2.5 (± 0.7), and -2.4 (± 1.3), respectfully. Mean length of therapy was 12 ± 2 months (range 9-18 months). T-scores and BMD significantly improved at all sites except for a significant decrease in T-score at the 1/3 radius. After 1 year of follow-on anti-resorptive treatment, T-scores and BMD significantly increased at the total hip and at the lumbar spine compared to post-abaloparatide, with nonsignificant changes in the femoral neck and 1/3 radius. There was one reported fracture. Eighteen patients (19.8%) discontinued therapy due to adverse drug reactions and there was a 72.5% medication persistence rate. Abaloparatide is effective in increasing BMD and T-scores and in preventing osteoporosis-related fractures. While significant barriers to anabolic osteoporosis treatment remain, involvement of a pharmacist-led clinic may increase medication persistence.