A self-drilling, self-tapping bone screw includes a body having a head at one end and a cutting end at an opposite end, the cutting end having a generally flat cutting surface supporting two symmetrical cutting edges which extend from the longitudinal centerline to diametrically opposed thread start points. A recess is formed in the head for receiving an end of an insertion tool. A dual lead thread extends outwardly from the body in a spiral path from the cutting end towards the head. The dual lead thread pitch is tapered towards the cutting end, and transitions to a straight or slightly tapered thread towards the head.