Objective To investigate the application effect of remote Teach-back method on the precise management of elderly patients with osteoporosis (OP). Methods From June to September 2016, the elderly outpatients with OP were selected and randomly divided into the conventional treatment group and the remote Teach-back comprehensive treatment group. The remote Teach-back comprehensive treatment group was given the mobile Internet (WeChat) on the basis of conventional treatment to guide patients with remote OP treatment. The OP knowledge, OP self-efficacy, activities of daily living (ADL), bone mineral density (BMD) and other indicators were compared between the two groups after 12 months of treatment. Results A total of 80 elderly patients with OP were included, with 40 patients in each group. The comparison of the improvement values of the two groups showed that the remote Teach-back comprehensive treatment group was superior to the conventional treatment group in terms of exercise knowledge, calcium knowledge, exercise performance, ADL and BMD (P<0.05). Among them, the improvement in exercise knowledge intervention in the remote Teach-back group and the conventional treatment group were 1.870 (1.098, 2.870) and 0.670 (0.043, 1.283); the improvement values of calcium knowledge intervention in the two groups were 2.495 (1.860, 3.455) and 0.250 (–0.810, 0.705); the improvement values after exercise intervention in the two groups were 15.015 (10.490, 26.175) and 6.045 (1.405, 13.545); the improvement of ADL in the two groups were 13.565 (4.053, 23.768) and 2.245 (–4.953, 7.872); the improvement of lumbar 1-waist 4 BMD in the two groups were 0.155 (0.010, 0.313) g/cm2 and 0.045 (–0.095, 0.160) g/cm2; the hip BMD improvement values of the two groups were 0.130 (–0.023, 0.245) g/cm2 and 0.035 (–0.043, 0.165) g/cm2. There was no significant difference in OP knowledge between the two groups (P>0.05). Conclusions Remote Teach-back online education makes OP management more effective. Relying on the characteristics of rehabilitation education and rehabilitation training, we will establish an advantageous management model to prevent the occurrence of OP and fragility fractures and improve the quality of life.