Objective To investigate the clinical outcome of fixation and autograft through the pedicle of fractured vertebrae for thoracolumbar burst fracture. Methods 138 cases with thoracolumbar burst fracture were retrospectively analyzed. 30 cases (group A) accepted 4 pedicle screw fixation with autogrft, and other 108 cases (group B) accepted internal fixation through the pedicle of fractured vertebrae with autogrft. All the cases were followed up for 22~72 months. Results The fractured vertebral height and Cobb's angle recovered and the neurological function improved after treatment in both groups (P<0.05), but there was no significant difference between 2 groups. There was significant difference in Visual Analogue Score for back pain (P<0.05). Conclusion Vertebral pedicle screw fixation with transpedicular autograft is an effective operation for thoracolumbar burst fracture, especially on back pain.