Renal osteodystrophy (ROD) refers to the skeletal alterations of chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with chronic kidney disease (CKD). Tetracycline-labeled bone biopsy is a golden standard for the diagnosis and classification of ROD. However, bone biopsy is often rejected by the patients and professionals due to the invasive operation. This review focuses on recent advances in the diagnosis of ROD, including modified bone biopsy, non-invasive imaging techniques, and novel bone turnover markers, enabling to develop a non-invasive and accurate virtual bone biopsy that improves diagnostic performance.