Background/Objectives: Vertebral fractures (VFs) often remain clinically unrecognized. We estimated the prevalence of previously unrecognized VFs among older adults presenting with major nonvertebral fragility fractures and explored associated clinical characteristics. Methods: This single-center prospective observational study enrolled 49 consecutive patients aged ≥60 years presenting with low-energy proximal femur, proximal humerus, or distal radius fractures between January 2023 and January 2024. Standardized thoracolumbar radiographs were evaluated using a combined modified algorithm-based qualitative and Genant semiquantitative approach. FRAX probabilities were calculated without bone mineral density. Associations were examined in exploratory unadjusted analyses. Results: Previously unrecognized VFs were found in 22/49 patients (44.9%; Wilson 95% CI, 31.9–58.7%), comprising 34 fractures. The most frequently affected levels were L2 (10/34) and T12 (8/34). A prior fracture history was associated with newly detected VFs in exploratory analysis (p = 0.002). Mean FRAX major osteoporotic fracture probability without bone mineral density was 16.66 ± 10.59% in patients with and 9.72 ± 7.80% in those without a newly identified VF (mean difference 6.94 percentage points; 95% CI, 1.45–12.43; p = 0.011). Conclusions: Previously unrecognized VFs were frequent in this small, predominantly hip-fracture cohort. The findings suggest a potential diagnostic gap and justify larger studies assessing targeted vertebral imaging in secondary fracture prevention; they do not establish a benefit from universal screening.