A total of 8 randomized controlled trials were included for data on efficacy, and 9 randomized controlled trials were included for data on harms, in this meta-analysis which investigated the effects of vitamin D and/or calcium supplementation in community-dwelling adults over the age of 50 years. Overall, quantitative and qualitative assessment of fractures rates from efficacy studies demonstrated no significant differences between vitamin D alone, calcium alone, and vitamin D plus calcium compared to placebo. In the harms analyses, all-cause mortality and cardiovascular events likewise did not significantly differ between groups, though the incidence of kidney stone development was greater among groups administered vitamin D plus calcium compared to placebo.