【Objective】 To compare the efficacy of percutaneous vertebroplasty （PVP） and facet blocking （FB） in the treatment of osteoporotic vertebral compression fractures. 【Methods】 From January 2015 to June 2019， 162 patients with osteoporotic vertebral compression fracture were treated with PVP and FB. Among them， PVP group （86 cases） received PVP treatment and FB group （76 cases） received FB treatment. We compared the perioperative related indexes， the height of the anterior edge of the injured vertebrae， the sagittal kyphosis Cobb angle， visual analogue score， dysfunction index and lumbar dysfunction score of preoperative and postoperative follow-up （1 day， 1 week， 1 month， 3 months， 6 months， and 12 months） in both groups. 【Results】 There was significant difference in operation time between PVP group ［（34.25±6.04）min）］ and FB group ［（21.47±4.58）min］ （P<0.05）. There was no significant difference in the height of the anterior edge of injured vertebra between the two groups before operation （P>0.05）， but there was significant difference in the height of anterior margin of injured vertebrae between the two groups at 3 days， 6 months and 12 months after operation （P<0.05）. In FB group， there was no significant change in the height of the anterior edge of the injured vertebrae at 3 days， 6 months and 12 months after operation. The two groups did not significantly differ in Cobb angle before operation （P>0.05）， but after operation（P<0.05）. The scores of VAS， ODI and RMD were lower in PVP group than in FB group 1 day and 1 week after operation （P<0.05）， but they did not significantly differ after follow-up for more than one month （P>0.05）. 【Conclusion】 Both PVP group and FB group have effectively relieved pain. The results of this study suggest that FB can become an alternative treatment for PVP in some patients， such as the poor， elderly and pain-tolerant ones.