Objective:To assess the effect and safety of bone-filling mesh container (BFC) and percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compression fractures (OVCF).Methods:PubMed, Web of Science, Cochrane Library, CNKI, VIP, CBM and Wanfang database were searched by computer from inception to September 2019, for the randomized controlled trial (RCT) or case-control trial (CCT) that compared the treatment of OVCF using BFC and PKP. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.3. The literature search results, basic characteristics of the included studies, operation time, postoperative visual analogue score (VAS), Oswestry disability index (ODI), Cobb's angle, leakage rate of the bone cement and publication bias were evaluated.Results:Only 5 RCTs and 5 CCTs involving 668 patients were included. Compared with the PKP group, the BFC group showed no significant difference in postoperative VAS ( MD=-0.06, 95% CI -0.24-0.37), ODI ( MD=-0.20, 95% CI-1.13-0.73) and Cobb's angle ( MD=0.18, 95% CI-0.05-0.91), while there were significant differences in operation time ( MD=-3.07, 95% CI-5.53--0.60) and leakage rate ( OR=0.21, 95% CI 0.12-0.36). Funnel plots showed that there was no significant asymmetry among the above indicators, suggesting that publication bias had little effect on the results. Conclusion:BFC is as effective as PKP in the postoperative efficacy of OVCF, but is superior in operation time and leakage rate of bone cement.