A retrospective cohort study using Quebec’s Fee-for-Service Medical Services Database (FSMRA) was conducted to develop and validate an algorithm for identifying new cases of fragility fractures (FF). The use of the validated algorithm and the linkage of medical and administrative data made it possible to quantify the incidence of OF and assess their impact on the use of medical resources. The algorithm’s validity varies by fracture site and is high for most sites. Based on the validated algorithm, the most common fractures are those associated with osteoporosis. Hip and pelvic fractures are relatively rare before age 70 but increase substantially thereafter. A significant proportion of medical resources is devoted to these fractures due to frequent hospitalization. Regarding peripheral fractures, they occur frequently starting at age 50, and the clinical care associated with their treatment is substantial. In conclusion, the FSMRA enables the identification of incident FFs with a single population-based value for their surveillance. The methodology developed and the linkage of medical and administrative data demonstrate that it is possible to expand the surveillance of FF and to produce a comprehensive and detailed picture of their burden on the healthcare system. (R.A.)