Objective: To investigate the influence of low viscosity and high viscosity bone cement in PVP on active function, anatomical index and leakage rate of patients with severe osteoporotic vertebral compression fractures (OVCF). Methods: From October 2015 to June 2017, 136 patients with severe OVCF were chosen in the Central Hospital of Yuncheng and randomly divided into two groups according to the digital table, with 68 patients in each group.The control group was given low viscosity bone cement by PVP scheme, and the observation group was given high viscosity bone cement by PVP.The VAS score, ODI score, SF-36 score and kyphosis Cobb angle before and after operation, the recovery rate of injured vertebrae, bone cement injection volume and postoperative cement leakage rate of the two groups were compared. Results: There were no statistically significant differences in the VAS score, ODI score and SF-36 score before operation between the two groups(all P>0.05). The VAS score, ODI score and SF-36 score after operation of the control group were (1.90±0.32)points, (30.38±3.52)points, (76.07±9.38)points, respectively, which of the observation group were (1.94±0.34)points, (29.72±3.34)points, (77.10±9.60)points, respectively, which were significantly better than those before operation(control group: t=4.27, 5.01, 4.02; observation group: t=4.21, 4.89, 3.87, all P<0.05). There were no statistically significant differences in the VAS score, ODI score and SF-36 score after operation between the two groups(all P>0.05). The kyphosis Cobb angle after operation of the observation group was (14.02±2.59)°, which was significantly lower than (16.83±3.31)° of the control group and (27.78±4.09)° before operation (t=4.99, 2.64, all P<0.05). The recovery rate of injured vertebrae of the observation group was (28.34±5.70)%, which was statistically significantly higher than (22.72±4.16)% of the control group (t=3.42, P<0.05). There was no statistically significant difference in the bone cement injection volume between the two groups(P>0.05). The incidence rate of bone cement leakage in the observation group was 10.29%(7/68), which was significantly lower than that in the control group [30.88%(21/68)](χ²=12.15, P<0.05). Conclusion Low viscosity and high viscosity bone cement in PVP in the treatment of patients with severe OVCF possess the same clinical effects on relieve pain and improve activity and quality of life; but high viscosity bone cement application can efficiently improve the anatomical index of injured vertebrae and avoid postoperative cement leakage.