Abstract：Objective：To discuss the clinical effect of modified Taohong Siwu tang for senile osteoporotic thoracolumbar vertebral compression fractures and its effect on the expression of vascular endothelial growth factor(VEGF). Methods：A total of 94 cases of patients with osteoporotic thoracolumbar vertebral compression fractures were divided into the control group and the observation group according to the random number table method，47 cases in each group．The control group was given routine western medicine combined with over-extension reduction，and the observation group was additionally given modified Taohong Siwu tang based on the treatment of the control group. The clinical effect was compared between the two groups. Before and after treatment，the pain of patients was evaluated via Visual Analogue Scale(VAS)；their thoracolumbar vertebral function was evaluated via Oswestry Disability Index(ODI)； the levels of VEGF in serum were detected. Results： The total effective rate was 91.49% in the observation group，higher than that of 76.60% in the control group，the difference being significant(P＜0.05)．Before treatment，there was no significant difference being found in the comparison of the scores of VAS and ODI between the two groups(P＞0.05)． After treatment， the scores of VAS and ODI in the two groups were decreased when compared with those before treatment(P＜0.05)，and the two scores in the observation group were lower than those in the control group(P＜0.05)． Before treatment， there was no significant difference being found in the comparison of bone mineral density and the levels of VEGF in serum between the two groups(P＞0.05)． After treatment， bone mineral density and the levels of VEGF in serum in the two groups were increased when compared with those before treatment(P＜0.05)， and the two indexes in the observation group were higher than those in the control group(P＜0.05)． Conclusion： Based on routine western medicine combined with over- extension reduction， the additional application of modified Taohong Siwu tang can increase the curative effect in treating senile osteoporotic thoracolumbar vertebral compression fractures，improve bone mineral density and lumbar vertebral function，and alleviate pain．