Postmenopausal osteoporosis presents a significant health challenge due to its detrimental impact on bone density, fracture risk, and overall quality of life. Conventional treatments, while effective, are associated with limitations such as side effects and compliance issues, prompting the exploration of alternative therapies. Herbal medicine has garnered attention as a potential adjunct or alternative to conventional treatments, with Piper nigrum (black pepper) and Linum usitatissimum (flaxseed) emerging as promising candidates for osteoporosis prevention and management. This review examines the preventive effects of a herbal extract combination of Piper nigrum and Linum usitatissimum on postmenopausal osteoporosis. Beginning with an overview of the background and prevalence of postmenopausal osteoporosis, this review discusses the limitations of current treatments and the growing interest in natural remedies. Phytochemical analyses reveal the key active compounds in Piper nigrum and Linum usitatissimum, along with their pharmacological properties relevant to bone health. Mechanistic insights highlight the anti-inflammatory, antioxidant, and hormonal modulation effects of these herbal extracts, elucidating their potential mechanisms of action. Preclinical and clinical evidence demonstrate the efficacy of Piper nigrum and Linum usitatissimum in improving bone density, reducing bone resorption, and enhancing bone formation in animal models and postmenopausal women. Considerations for integration into clinical practice, comparisons with conventional therapies, and safety profiles are discussed, along with future research directions, including the need for larger, long-term studies and advances in formulation technology. Overall, this review underscores the potential of Piper nigrum and Linum usitatissimum as natural alternatives for the prevention and management of postmenopausal osteoporosis, offering hope for improved outcomes and enhanced quality of life for affected individuals. Keywords: postmenopausal osteoporosis, herbal medicine, Piper nigrum, Linum usitatissimum, phytochemistry, mechanisms of action, clinical evidence