Background: Lower semen quality is associated with increased mortality and morbidity, which may include osteoporosis. Objective: To assess whether infertile men have a lower bone mineral density (BMD) compared with fertile men at the time of fertility workup. Methods: A total of 146 men from infertile couples with unexplained impaired semen quality, characterized by sperm concentration < 20 million/mL, progressive motility < 50% or < 12% morphologically normal spermatozoa. Men with infertility due to a genetic etiology or a condition that could cause testicular damage were excluded. A total of 271 men from couples with an ongoing naturally conceived pregnancy served as a control group. Lumbar, femoral, and total body BMD were measured by dual X-ray absorptiometry. Results: Infertile men had similar BMD compared with fertile men (Beta coefficient (g/cm2) and 95% confidence interval for the difference between the two groups: −0.02 (−0.05; 0.01) for lumbar BMD, −0.02 (−0.05; 0.01) for femoral neck BMD, −0.01 (−0.04; 0.02) for total femur BMD, and −0.01 (−0.03; 0.01) for total body BMD). Semen parameters were not associated with BMD measurements. Furthermore, BMD did not differ between infertile men with the lowest semen quality vs. infertile men with better semen quality nor between infertile men with low testosterone vs. fertile men with normal testosterone levels. Conclusion: Bone mineral density is preserved in men with unexplained infertility at the time of fertility workup.