Retrospective study of 59 patients of medically related osteonecrosis of the jaw admitted to the Maxillofacial Surgery Clinic, St. Marina University Hospital, Varna Medical University for a period of 10 years (2000-2019). Major malignancies were breast and prostate carcinoma at 56% and 20%, respectively. There is an increase in the annual incidence of osteonecrosis and an average incidence of 10.17% of those treated for the entire period. Mean age was 64 ± 14 years and there was female predominance and predominance of localization of MRONJ in the lower jaw. T2DM and hypertension were 36% and 64% of all patients. In 24 patients with MRONJ vitamin D levels were low in 100% of patients.