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Objective: To explore postmenopausal women with osteoporotic vertebral compression fractures Treated by Percutaneous kyphoplasty Combined Zoledronic Acid. Methods: Review of 120 cases who were postmenopausal women with osteoporotic vertebral compression fractures confirmed by X-rays, CT, MRI and speculated the degree of osteoporosis by DEXA (dual energy X-ray absorptiometry) were admitted in our departments. All of cases underwent PKP (bilateral) surgery were fresh fractures. Aclasta is given to5mg (100 m L) infusion after postoperative three days. On 96 patients before surgery, after surgery one week before the end of follow-up surgery VAS score, functional disability index (ODI), JOA score were compared. Results: All of patients were followed up 3 to 36 months, an average of 24 months. 16 cases of varying degrees of bone cement let out, seepage or parts of the vertebral disc space. Compared postoperative week, the last follow-up with surgery by VAS, JOA score and ODI, the difference was statistically significant (P values were less than 0.00), whereas, the first two had no statistically significant (P values were 0.18,0.49,0.50). Conclusion: Postmenopausal women with osteoporotic vertebral compression fractures treated by percutaneous kyphoplasty combined Zoledronic Acid has some advantages, such as safe, effective lasting and so on. [ABSTRACT FROM AUTHOR]