OBJECTIVE： To explore the clinical effect and safety of Zoledronic acid injection combined with percutaneous vertebroplasty for osteoporotic vertebral compression fracture （OVCF）. METHODS： A total of 130 OVCF patients selected from our hospital during Jan. 2014-Dec. 2015 were divided into observation group and control group according to random number table， with 65 cases in each group. Control group was given bone cement by percutaneous vertebroplasty. Observation group was additionally given Zoledronic acid injection 5 mg， ivgtt， once a year （dripping time ≥15 min）， on the basis of control group. Both groups were given calcium and vitamin D orally after surgery. VAS scores， Oswestry disability index （ODI） and ADL scores were observed in 2 groups 1 week and 6 months after treatment. Bone density of lumbar vertebra L1-L4 and femoral neck were detected in 2 groups after one year of treatment. RESULTS： Before treatment， there was no statistical significance in VAS scores， ODI or ADL scores，bone density of lumbar vertebra LI-L4 and femoral neck between 2 groups （P＞0.05）. VAS scores and ODI of 2 groups were decreased significantly， while ADL scores were increased significantly 1 week and 6 months after treatment； observation group were significantly better than control group， with statistical significance （P＜0.05）. One year after treatment， bone density of lumbar vertebra L1-L4 and femoral neck in observation group were significantly higher than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups as fever， dizziness， bone and joint pain， muscle soft tissue pain and new fracture （P＞0.05）. CONCLUSIONS： Zoledronic acid combined with percutaneous vertebroplasty in the treatment of OVCF can significantly relieve pain， improve dysfunction and enhance bone density with good safety.