Bone material is built in a complex multiscale arrangement of mineralized collagen fibrils containing water, proteoglycans and some noncollagenous proteins. This organization is not static as bone is constantly remodeled and thus able to repair damaged tissue and adapt to the loading situation. In preventing fractures, the most important mechanical property is toughness, which is the ability to absorb impact energy without reaching complete failure. There is no simple explanation for the origin of the toughness of bone material, and this property depends in a complex way on the internal architecture of the material on all scales from nanometers to millimeters. Hence, fragility may have different mechanical origins, depending on which toughening mechanism is not working properly. This article reviews the toughening mechanisms described for bone material and attempts to put them in a clinical context, with the hope that future analysis of bone fragility may be guided by this collection of possible mechanistic origins.