Purpose: This study compared the 3-month treatment effects of teriparatide and percutaneous vertebroplasty for acute osteoporotic vertebral compression fractures. Materials and Methods: A retrospective study was conducted on 76 patients diagnosed with acute osteoporotic vertebral compression fractures from January 1, 2020 to December 31, 2022. The patients were divided into the teriparatide group and the percutaneous vertebroplasty+alendronate group. The visual analog scale (VAS), Oswestry disability index (ODI), and height of the vertebrae anterior wall were measured before treatment and at 1 and 3 months after treatment. Results: Of the 76 patients, 42 were treated with teriparatide, and 34 were treated with percutaneous vertebroplasty. The symptoms improved in both groups, with a decrease in the VAS and ODI scores at 1 and 3 months after treatment, respectively. On the other hand, there was no significant difference in the VAS, ODI score, and anterior vertebral body height between the two groups before treatment and at 1 and 3 months after treatment. Conclusion In the treatment of acute osteoporotic vertebral compression fractures, conservative treatment using teriparatide showed similar short-term (3 months) treatment results to percutaneous vertebroplasty in terms of improvement in back pain and function and degree of reduction in anterior vertebral body height.