Abstract： Objective： To observe the clinical effect of Taohong Siwu tang combined with functional exercise for osteoporotic thoracolumbar vertebral compression fractures in senile patients. Methods：A total of 92 cases of senile patients with osteoporotic thoracolumbar vertebral compression fractures were selected and randomly divided into the the observation group and the control group，49 and 43 cases in each group respectively. The control group was given western medicine combined with functional exercise， and the observation group was additionally given Taohong Siwu tang based on the treatment of the control group. After eight- week treatment， the clinical effect was observed in the two groups. Before treatment as well as on the 1st ，4th，and 8th week after treatment，the scores of Visual Analogue Scale(VAS) of pain were compared. Results： In the observation group， there were 32 cases with marked effect， 14 effective cases， and 3 ineffective cases； in the control group， there were 15 cases with marked effect， 19 effective cases， and 9 ineffective cases，the difference being significant(P＜0.05). As the time went on，the scores of VAS in the two groups were gradually decreased；on the 1st ，4th，and 8th week after treatment，the scores in the observation group were lower than those in the control group，differences being significant(P＜0.05). Conclusion：In the treatment of osteoporotic thoracolumbar vertebral compression fractures in senile patients， the therapy of Taohong Siwu tang combined with functional exercise can have satisfactory clinical effect.