The aim of this study was to evaluate the influence of microstructural parameters, such as porosity and osteon dimensions, on strength. Therefore, the predictive value of bone mineral density (BMD) measured by quantitative computed tomography (QCT) for intracortical porosity and other microstructural parameters, as well as for strength of cortical bone biopsies, was investigated. Femoral cortical bone specimens from the middiaphysis of 23 patients were harvested during total hip replacement while drilling a hole (dia. 4.5 mm) for the relief of the intramedullary pressure. In vitro structural parameters assessed in histological sections as well as BMD determined by quantitative computed tomography were correlated with yield stress, and elastic modulus assessed by a compression test of the same specimens. Significant correlations were found between BMD and all mechanical parameters (elastic modulus: r = 0.69, p < 0.005; yield stress: r = 0.64, p < 0.005). Significant correlations between most structural parameters assessed by histology and yield stress were discovered. Structural parameters related to pore dimensions revealed higher correlation coefficients with yield stress (r = −0.69 for average pore diameter and r = −0.62 for fraction of porous structures, p < 0.005) than parameters related to osteons (r = 0.60 for osteon density and average osteonal area, p < 0.005), whereas elastic modulus was predicted equally well by both types of parameters. Significant correlations were found between BMD and parameters related to porous structures (r = 0.85 for porosity, 0.80 for average pore area, and r = 0.79 for average pore diameter in polynomial regression, p < 0.005). Histologically assessed porosity correlated significantly with parameters describing porous structures and haversian canal dimensions. Our results indicate a relevance of osteon density and fraction of osteonal structures for the mechanical parameters of cortical bone. We consider the measurement of BMD by quantitative computed tomography to be helpful for the estimation of bone strength as well as for the prediction of intracortical porosity and parameters related to porous structures of cortical bone.