Objective To compare the efficacy of percutaneous kyphoplasty(PKP)with unilateral and bilateral punc-turing for treatment of the osteoporotic vertebral compression fracture(OVCF)in the elderly.Methods The 62 elder-ly patients with OVCFs who underwent PKP treatment were divided into unilateral group(32 cases)and bilateral group(30 cases),according to unilateral and bilateral puncture.The volume of bone cement injection and leakage sta-tus,intraoperative X-ray fluoroscopy time,operation time,postoperative pain VAS and imaging indexes were compared between the two groups.Results All patients were followed up for 6~13 months.The volume of bone cement injec-tion,intraoperative X-ray fluoroscopy time and operation time were less(shorter)in unilateral group than bilateral group(P<0.01).There was no statistical difference in postoperative pain VAS between the two groups(P>0.05).Bone cement leakage occurred in 3 cases in unilateral group and 7 cases in bilateral group,but there were no clinical symptoms.At postoperation,the anterior margin height of the injured vertebrae,the central height of the injured verte-brae and the Cobb angles of the two groups were improved than the preoperation(P<0.05),and there were no statis-tical differences between the two groups after surgery(P>0.05).Conclusions Both unilateral and bilateral punctu-ring PKP for treatment of elderly patients with OVCFs,which can improve patient′s pain symptoms,and correct kypho-sis deformity,restore the height of the injured vertebrae,and there are shorter time of X-ray fluoroscopy and operation time,and less volume of bone cement injection in unilateral puncture.