Purpose: the study presents German reference data for Digital X-ray Radiogrammetry (DXR) differentiated by male as well as female, and quantifies gender-specific and agerelated differences for all DXR-parameters. The study also documents the effects of different X-ray settings (e.g. radiographs of the wrist or the hand) on DXR-measurements. Patients and Methods: 2085 patients were prospectively enrolled (954 female / 1131 male) from data pool of 11915 patients with radiographs of the non-dominant hand or wrist. All patients underwent measurements of bone mineral density (BMD), cortical thickness (CT), bone width (W) and Metacarpal Index (MCI) using DXR-technology. Results: These data show a continuous age-related increase of the DXR-parameters to the point of peak bone mass, then a continuous decline beyond the peak bone mass with accentuated age-related cortical bone loss in women. Peak bone mass is reached at about 30-35 years for woman and 45-50 for men. Additionally males show a significantly higher DXR-BMD (mean: +12,8%) compared to the female cohort for all age groups. Rgarding the impact of various X-ray settings (X-ray wrist versus X-ray hand) no significant difference was observed between both groups in men as well as women. Conclusion: in conclusion the development of digital imaging technology has enabled more precise measurement of several radiogeometric features. The present study has estimated normative reference values for Digital X-ray Radiogrammetry in German Caucasian woman and men. Based on this reference data a valid and reliable quantification of disease-related demineralisation based on measurements of DXR-BMD and MCI is now available for the Caucasian ethnic group.