Objective To observe the correlation of MRI findings with treatment outcome of percutaneous kyphoplasty (PKP) in the acute phase of osteoporotic vertebral compression fracture (OVCF).Methods A total of 101 patients with single-segment OVCF undergone PKP in the acute phase were included in the study.There were 19 males and 82 females, at age range of 61 to 89 years (mean, 69.3 years).According to the T2WI signal intensity, the patients were divided into low signal group (Group A), low-medium signal group (Group B), medium signal group (Group C), and mediumhigh signal group (Group D).visual analogue scale (VAS) was used to evaluating the pain relief.Correlations of MRI signal with vertebral height, vertebral compression ratio, Cobb's angle change in each group were determined.Results All MRI images were shown as low signal in T1WI and high signal in FS-T2WI.On the T2WI images, the signal was medium-high in 14 vertebrae, medium in 18 vertebrae, low-medium in 31 vertebrae, and low in 38 vertebrae.Among four groups, the VAS score, vertebral body height, vertebral compression ratio and Cobb's angle changes before operation showed no statistical difference compared with those after operation (P ＜ 0.05).Conclusions MRI findings are primarily low or medium signal on T2WI images in the acute phase of OVCF, which shows insignificant correlation with effect of PKP.However, PKP is effective in the treatment of OVCF.