Background, Motivation and Objective Structural decay of bone is not fully assessed by current X-ray methods, and there is an unmet need in identifying women at risk of fracture who should receive a treatment. The last decade has seen the emergence of ultrasound axial transmission (AT) techniques to assess cortical bone, known for its key role in the mechanical strength of bone. Recent AT techniques exploit the multimode waveguide response of long bones (Vallet et al. IEEE IUS 2014). Applied to long bones such as the radius or tibia, guided waves-based approaches would be expected to provide estimates of important bone quality factors, such as cortical thickness and porosity, which cannot easily be captured by X-ray densitometry techniques (DXA). The objective of this cross sectional study was to evaluate if a new guided waves-based AT prototype can discriminate between fractured and non fractured postmenopausal women.