Abstract： Objective： To observe the clinical effect of Bushen Huoxue tang for osteoporotic vertebral compression fracture(OVCF) and its effect on bone metabolism. Methods：A total of 60 cases of OVCF patients were randomly divided into the observation group and the control group， 30 cases in each group. Both groups were treated with percutaneous vertebroplasty(PVP). On the 3rd day after surgery，the control group was given alfacalcidol soft capsules，and the observation group was additionally given the oral administration of Bushen Huoxue tang based on the treatment of the control group. The clinical effect was compared between the two groups. Before and after treatment，pain degree，limb function，as well as the indexes of bone density and bone metabolism were compared between the two groups. The adverse reactions were recorded in the two groups. Results： The total effective rate was 90.00% in the observation group， and 66.67% in the control group， the difference being significant(P＜0.05). After treatment， the scores of Visual Analogue Scale(VAS) and Oswestry dysfunction index(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). After treatment， the bone densities of L1~4 and the greater trochanter were increased when compared with those before treatment(P＜0.05)， the bone densities and the greater trochanter in the observation group were larger than those in the control group(P＜0.05). After treatment ， levels of alkaline phosphatase(ALP) ， bone gammacarboxyglutamic acid-containing protein(BGP) ， and osteoprotegerin(OPG) in serum in the two groups were increased when compared with those before treatment(P＜0.05)， and levels of urine deoxypyridinoline(DPD) were decreased(P＜0.05). After treatment， levels of ALP， BGP， and OPG in serum in the observation group were higher than those in the control group(P＜0.05)，and levels of DPD in urine were lower (P＜0.05). No severe adverse reactions occurred in the two groups. Conclusion： Bushen Huoxue tang has a significant curative effect in the treatment of OVCF. It can effectively relieve pain，improve limb function and bone density，and promote bone growth with high safety.