The finite element method, which has been successfully applied to studies of the elastic properties of trabecular bone, is now being used to simulate its failure. These simulations have used a geometrically linear (linear kinematic) approximation to the total stiffness matrix;​ nonlinear terms in the total stiffness matrix have been excluded from the computation in order to achieve efficiency. Because trabecular bone appears to be a slender (i.e., geometrically nonlinear) structure, we studied the validity of the linear kinematic approximation for simulating its failure. Two cases, designed to bracket the extremes of stability behavior, were explored:​ a single representative spicule of trabecular bone (case 1) and a volume of trabecular bone consisting of relatively low aspect ratio members (case 2). For case 1, geometrically linear (GL) and nonlinear (GNL) analyses were performed with two different materials models:​ a plastic damage model and a brittle damage model. When GNL terms were included in the total stiffness matrix, we found that load-path bifurcation preceded tissue failure regardless of the form of the damage model. This bifurcation was the result of a complex coupling between material yield and structural instability. The nature of this coupling was highly sensitive to the form of the damage model. None of these behaviors was observed in the linear analyses, where failure was insensitive to the form of the damage model and where structural instabilities were prevented from occurring. For case 2, compressive loading of a volume of trabecular bone, geometric nonlinear effects were pronounced. There was a bifurcation in load response that resulted in large apparent strain to failure. The GL simulations, on the other hand, precluded this bifurcation. We hypothesize that trabecular bone is a geometric nonlinear structure;​ nonlinear terms must be included in the total stiffness matrix to accurately simulate its failure.