Abstract： Objective： To observe the clinical efficacy of Qianggu Yin combined with modified Five-Animal Exercises on the basis of conventional western medicine in the treatment of elderly female osteoporosis of kidney deficiency and blood stasis type. Methods：A total of 120 elderly female patients with osteoporosis of kidney deficiency and blood stasis type admitted to the Second Affiliated Hospital of Zhejiang Chinese Medical University from January 2020 to December 2024 were enrolled and randomly divided into a control group and a treatment group using the random number table method，with 60 cases in each group，and finally 54 cases in each group completed the study. The control group was treated with Alfacalcidol Soft Capsules and Calcium Carbonate and Vitamin D3 Tablets，while the treatment group was additionally treated with Qianggu Yin Granules and modified Five-Animal Exercises on the basis of the control group. Both groups were treated for 12 months. The changes in gait parameters，lumbar vertebral bone mineral density（ BMD） measured by quantitative computed tomography（ QCT），and Visual Analogue Scale（ VAS） scores were compared between the two groups before treatment， at 6 months after treatment， and at 12 months after treatment. Results：After 6 months of treatment，the total distance，average speed，and left and right step width coefficients of variation in the treatment group all improved compared with those before treatment，and the right step width coefficient of variation in the control group improved compared with that before treatment （P＜0.05）. After 12 months of treatment， the total distance，average speed，left and right step length，and left and right step width coefficients of variation in the treatment group all improved compared with those before treatment （P＜0.05），and the total distance，average speed， and left and right step width coefficients of variation in the control group improved compared with those before treatment （P＜0.05）， and the left and right step length and left and right step width coefficients of variation in the treatment group were superior to those in the control group at the same time point （P＜0.05）. After 12 months of treatment，the QCT results showed that the lumbar BMD in both groups increased compared with that before treatment， and the BMD in the treatment group was higher than that in the control group （P＜0.05）. After treatment， the VAS score in the treatment group decreased compared with that before treatment （P＜0.05）， and there was a significant interaction effect between groups over time for VAS score change （P＜0.001）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： Qianggu Yin combined with modified Five-Animal Exercises can improve gait function，increase lumbar BMD，alleviate bone pain， and may improve fall-related functional indicators in elderly female patients with osteoporosis， showing favorable clinical application value.