Abstract：Objective：To observe the clinical effect of Guilu Qianggu Decoction combined with Zoledronic Acid Injection and Calcium Carbonate and Vatamin D3 Tablets on elderly patients with osteoporotic vertebral compression fractures （OLVCF） after percutaneous kyphoplasty （PKP）. Methods： A total of 90 cases of OVCF patients who underwent PKP at Anyang Hospital of Chinese Medicine from February to December 2022 were selected and divided into the control group and the observation group according to the random number table method，with 45 cases in each group. The control group was treated with Zoledronic Acid Injection Combined with Calcium Carbonate and Vatamin D3 Tablets，and the observation group was additionally treated with Guilu Qianggu Decoction based on the treatment of the control group. Both groups were treated for six weeks. Clinical effects， serum osteocalcin （BGP）， bone mineral density（ BMD），osteoprotegerin（ OPG），Oswestry Disability Index（ ODI） scores，traditional Chinese medicine（ TCM） syndrome scores， adverse reactions， and complications were compared between the two groups. Results： The total effective rate was 93.33% （42/45） in the observation group， higher than that of 77.78% （35/45） in the control group （P＜0.05）. Both groups showed increased levels of OPG，BGP，and BMD compared to before treatment，with the observation group having higher levels than the control group （P＜0.05）. TCM syndrome scores and ODI scores in the two groups were decreased when compared with those before treatment， with the observation group showing lower scores than the control group （P＜0.05）. No statistically signifcant differences were observe in the incidence of adverse reation and complications between the two groups （P＞0.05）. Conclusion： Guilu Qianggu Decoction combined with Zoledronic Acid Injection and Calcium Carbonate and Vatamin D3 Tablets for elderly patients with OVCF after PKP can improve osteoporsis，and improve lumbar function and TCM syndromes.