REMS technology performance has been evaluated through multicentre clinical studies. The work of Di Paola et al. has investigated precision and diagnostic accuracy of REMS in comparison with DXA on a sample of 2000 patients. A very high correlation has been observed between the T-Score values obtained by both technologies (Pearson correlation coefficient > 0.93; Cohen’s Kappa equals to 0.82 for lumbar spine and 0.79 for femoral neck) as well as a very low average BMD difference between the two techniques (mean ± 2 standard deviations): −0.004±0.088 g/cm for lumbar spine and −0.006±0.076 g/cm for femoral neck. Furthermore, specificity and sensitivity of REMS in the discrimination between osteoporotic and non-osteoporotic patients has been evaluated: sensitivity and specificity exceed 91% for both skeletal sites. Additional outcomes of this study are the values of precision and repeatability of REMS estimates, assessed using the Root Mean Square Coefficient of Variation (CV-RMS): precision has been evaluated as being 0.38% for lumbar spine and 0.32% for femoral neck, whereas the Least Significant Change (LSC) resulted in 1.05% and 0.88%, respectively. Finally, inter-operator repeatability has been calculated, which has resulted in 0.54% for lumbar spine and 0.48% for femoral neck. These values are significantly lower than those reported about DXA in the scientific literature and offer concrete advantages from the point of view of short-term follow-up of patients undergoing therapeutic treatments.