BACKGROUND: How to effectively treat recurrent osteoporotic vertebral compression fractures in the elderly over 65 years has become an issue of attention in the clinic. OBJECTIVE:To evaluate the clinical efficacy of percutaneous vertebroplasty with polymethylmethacrylate bone cement for treating elderly recurrent osteoporotic vertebral compression fractures. METHODS:Twenty-four patients with elderly osteoporotic vertebral compression fractures were divided into polymethylmethacrylate bone cement group (minimaly invasive group) and conservative treatment group on a voluntary basis (n=12 per group). Visual analog scale score for low back pain, Oswesty dysfunction index, ratio of the anterior/posterior margin height of the injured vertebra, Cobb angle and adverse reactions were compared between the two groups before and after treatment. RESULTS AND CONCLUSION:The 12-month folow-up was completed in al the patients. There was one case of bone cement breakage during treatment in the minimaly invasive group and one case of lower limb deep venous thrombosis in the conservative treatment group at 1 month after treatment. Compared with the conservative treatment group, the visual analog scale score, Oswesty dysfunction index, and Cobb angle were significantly lower, but the ratio of the anterior/posterior margin height of the injured vertebra was significantly higher in the minimaly invasive group at 3 days, 1, 3, 6 and 12 months after treatment (P < 0.05). These findings indicate that percutaneous vertebroplasty with polymethylmethacrylate bone cement for elderly recurrent osteoporotic vertebral fractures can strive for short-term pain relief and long-term recovery of the vertebral height and spinal Cobb angle, thereby significantly improving patient’s quality of life.