This paper reviews the changes in the quality of bone mineral with age and in disease. After a brief review of morphological changes with aging in mammalian bones, microradiography is compared to backscattered electron imaging and their use in bringing out subtle changes in bone mineralization outlined. Changes in the quality of bone with disease is described using osteoporosis as an example. Chemical changes in the skeleton are then discussed and related to morphological changes. Finally, some examples of localized and generalized changes in bone mineral are given. This paper emphasizes that understanding the nature of the mineral phase in bone as well as its heterogeneity and its changes with age and in disease is essential to the elucidation of skeletal physiology and pathology.