Objective To investigate the status of vertebral compression fracture(VCF)in elderly patients with osteoporosis and analyze its influencing factors.Methods A total of 222 elderly patients with osteoporosis admitted to Department of Spinal Surgery in Affiliated Hospital of Zunyi Medical University from March 2019 to March 2023 were selected as the research objects by the convenient sampling method,and clinical data of the patients were collected.Patients were divided into VCF group(n=98)and non-VCF group(n=124)based on whether or not VCF occurred.Logistic regression was used to analyze the influencing factors of VCF in elderly patients with osteoporosis.Results The incidence of VCF in 222 elderly patients with osteoporosis was 44.1%(98/222).The results of Logistic regression analysis showed that a history of falls(0R=2.968,95%CI:1.154-7.736,P=0.024),no history of osteoporosis drug treatment(OR=4.707,95%CI:1.525-14.531,P=0.007),body mass index>24.0 kg/m2(OR=4.586,95%CI:2.071-10.158,P<0.001),lower bone density T values(OR=3.221,95%CI:2.194-4.731,P<0.001)and low albumin(OR=0.828,95%CI:0.752-0.913,P<0.001)were risk factors for VCF in elderly patients with osteoporosis.Conclusions The incidence of vertebral compression fracture is high in elderly patients with osteoporosis,among which a history of falls,no history of osteoporosis drug treatment,body mass index greater than 24 kg/m2,lower bone density T-values and low albumin are the main influencing factors that affect the occurrence of vertebral compression fracture in elderly patients with osteoporosis.Clinical medical staff should pay attention to these risk factors,identify the risk of fractures in elderly patients early and take targeted intervention measures.