Background: Bone mineral density and structural integrity are critical in orthopedic treatments and forensic investigations. Changes in bone characteristics due to fractures and decomposition affect clinical management and post-mortem analysis. Understanding these variations is essential for improving fracture care and forensic identification techniques. This study compares bone mineral density and structural properties among healthy, fractured, and decomposed bones, analyzing their implications for medical and forensic applications. Methods: A study was conducted at Kabir Medical College Department of Forensic Medicine, Gandhara University Peshawar. Total of 92 bone samples were analyzed and categorized into three groups: healthy (n = 30), fractured (n = 32), and decomposed (n = 30). Bone mineral density, cortical thickness, trabecular integrity, and porosity were measured using dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT). Fracture healing was assessed based on callus formation and osteophyte presence, while decomposition was evaluated through post-mortem interval, environmental exposure, and collagen degradation. Statistical analyses, including ANOVA and correlation tests, were conducted to determine significant differences among the groups. Results: Healthy bones exhibited the highest bone mineral density and lowest porosity, while fractured bones showed moderate reductions in density with variations in healing outcomes. Decomposed bones had the lowest mineral density and highest porosity, with degradation influenced by environmental factors such as temperature and soil composition. Significant differences were observed across all groups (p < 0.001), confirming progressive structural deterioration in fractured and decomposed bones. Conclusion: The findings reinforce the importance of bone health in preventing fractures and improving healing outcomes while providing forensic insights into skeletal decomposition. This study highlights the need for early intervention in fracture care and the role of environmental factors in post-mortem bone degradation, contributing to both medical and forensic fields.