Osteoporosis is a major public health concern acting as a leading cause of morbidity and mortality in our aging population and affecting over 200 million people worldwide. The financial burden from the costs of osteoporotic fractures is increasing at alarming rates. As current therapies for osteoporosis have numerous shortcomings, the development of new osteogenic therapies is imperative. Cell-mediated therapy using mesenchymal stem cells (MSCs) holds great promise for skeletal disorders. However, its reported clinical outcomes have been suboptimal, requiring a more precise understanding of the molecular and epigenetic regulatory mechanisms for MSC differentiation.