OBJECTIVE： To explore the effects of zoledronic acid on bone mineral density （BMD） and bone metabolism in patients with systemic lupus erythematosus （SLE） complicated with osteoporosis. METHODS： Clinical information of 70 patients with SLE complicated with osteoporosis who volunteered for the study were collected from our hospital during Mar. 2012 to Jan. 2015 in our hospital. They were divided into observation group and control group according to therapy plan， with 35 cases in each group. Both groups were given prednisolone and hydroxychloroquine for maintenance treatment of SLE. Control group was additionally given traditional anti-osteoporosis agents as calcium and calcitriol. Observation group additionally received Zoledronic acid injection 4 mg， ivgtt， dripping time＞30 min， once a year， on the basis of control group for 3 years.The lumbar BMD， femoral neck BMD， large rotor BMD， Ward’s triangle BMD before and after 1 year of treatment， and serum levels of calcium， phosphorus， β-CTX， N-MID and B-ALP in 2 groups before and after 1 week and 1 year of treatment were recorded as well as the complications during treatment. RESULTS： There was no statistical significance in above indexes between 2 groups before treatment （P＞0.05）. After 1 year of treatment， BMD of those parts in 2 groups were increased significantly， and those of observation group were significantly higher than those of control group， with statistical significance （P＜0.05）. After 1 year of treatment， there was no statistical significance in serum levels of calcium， phosphorus between 2 groups and in serum levels of β-CTX， N-MID and B-ALP in control group compared to before treatment， without statistical significance （P＞0.05）. Serum levels of β-CTX， N-MID and B-ALP in observation group were significantly lower than before treatment and control group， with statistical significance （P＜0.05）. The incidence of fracture and femoral head necrosis in 2 groups were 5.71％ and 25.71％ within 1 year， with statistical significance （P＜0.05）. CONCLUSIONS： Zoledronic acid can effectively relieve bone absorption， reduce bone metabolism rate， increase BMD， and reduce the risk of fracture and the femoral head necrosis in patients with SLE complicated with osteoporosis.