Abstract： Objective： To observe the clinical effect of Bushen Zhuangjin Decoction combined with percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF). Methods：A total of 96 cases of patients diagnosed with OVCF were selected and divided into two groups according to the random number table method， with 48 cases in each group. Both groups were treated with PKP； the control group was treated with Calcium Carbonate D3 Tablets and Guhua Sanchun Pills； the observation group was additionally treated with Bushen Zhuangjin Decoction based on the treatment of the control group. The clinical effects in three months after operation in the two groups were observed；the changes in Japanese Orthopaedic Association (JOA) scores， Oswestry Disability Index (ODI)， and bone metabolism indexes [calcitonin，C-telopeptide of typeⅠcollagen (CTX -Ⅰ)，bone alkaline phosphatase (BALP)，typeⅠ procollagen amino terminal peptide (PⅠNP)] before and after treatment were compared between the two groups；the changes in bone mineral density of injured vertebra，hip joint，and femoral neck bone before and after treatment were compared between the two groups； the incidence of adverse reactions was compared between the two groups. Results：After treatment，the clinical effect in the observation group was significantly higher than that in the control group (P＜0.05). After treatment，JOA scores，calcitonin， and BALP levels in the two groups were higher than those before treatment (P＜0.05)， and the above indexes in the observation group were higher than those in the control group (P＜0.05). After treatment， the levels of ODI，CTX-Ⅰ，and PⅠNP in the two groups were lower than those before treatment (P＜ 0.05)，and the above levels in the observation group were lower than those in the control group (P＜0.05). After treatment， bone mineral density of injured vertebra， hip joint， and femoral neck bone in the two groups was increased (P＜0.05)， and the bone mineral density in the observation group was higher than that in the control group (P＜0.05). The differences of JOA scores， ODI scores， bone metabolism indexes， and bone mineral density indexes before and after treatment in the observation group were greater than those in the control group (P＜0.05). During treatment， there was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups (P＞0.05). Conclusion：Bushen Zhuangjin Decoction for OVCF after PKP can improve the clinical effect，the lumbar function，and the levels of bone metabolism，promote fracture healing and vertebral height recovery，and enhance bone mineral density of patients，with medication safety.