Objective To investigate comparative analysis of PKP and conservative treatment for old osteoporotic vertebral compression fractures ,to provide a reference for clinical treatment .Methods From January 2011 to March 2014 48 cases of OVCF patients were selected ,they were divided into two groups according to treatment which were observation group (26 cases) and con‐trol group (22 patients) ,control group with the implementation of conservative treatment ,observation group was implemented with surgical treatment for patients with PKP .Two groups of patients before and after treatment quality of life scores (SF‐36) ,pain vis‐ual analogue scale (VAS) ,Oswestry Disability Index and radiographic findings were compared .Results The observation group and the control group before and after treatment VAS scores were significantly different (F= 84 .393 ,P= 0 .019 ;F= 61 .388 ,P=0 .028);VAS score in observation group after treatment 1d ,6 months were significantly lower than the control group ,the difference was statistically significant (t= -18 .843 ,P=0 .000;t= -17 .174 ,P=0 .000);SF‐36 scores in the observation group was 85 .18 ± 8 .01 ,significantly higher than 74 .29 ± 6 .93 ,the difference was statistically significant (t=8 .569 ,P=0 .006);in observation group after treatment Oswestry disability scores compared with the control group ,the difference was statistically significant (t=6 .217 , P=0 .010);in the observation group after 1 d ,6 months the middle of vertebral height was (19 .72 ± 2 .44) mm ,(19 .70 ± 2 .17) mm ,were higher than before treatment ,the difference was statistically significant (F=23 .221 ,P=0 .028) .Conclusion PKP can improve pain and quality of life for patients ,which is worthy of clinical application .