Abstract: Objective To observe the effect of high viscosity cement vertebroplasty in the treatment of osteoporotic vertebral compression fractures(OVCFs)in elderly women. Methods A total of 130 elderly female patients with OVCFs were selected and divided into two groups according to random number table method, with 65 patients per group. Both groups underwent bone cement vertebroplasty. The low viscosity group was given low viscosity bone cement vertebroplasty, and the high viscosity group was given high viscosity bone cement vertebroplasty. The postoperative leakage of bone cement, the height of injured vertebrae before and after the operation, and related indicators were observed in both groups. Results The postoperative bone cement leakage of the high viscosity group was 13.85%, which was significantly lower than 29.23% in the low viscosity group(P<0.05); the height of the injured vertebrae in the high viscosity group was significantly higher than that of the low viscosity group(P<0.05); the postoperative Visual Analogue Scale(VAS)scores in the two groups were lower than operation before(P<0.05), but no significant difference was found in two groups(P>0.05); the Cobb angle, front edge height to back edge height ratio, middle height ratio, and back edge height ratio after operation in the high viscosity group were significantly better than those in the low viscosity group(P<0.05). After 3 months of follow-up, the Japanese Orthopedic Association(JOA)score of the high viscosity group was significantly higher than that of the low viscosity group(P<0.05). Conclusion High viscosity bone cement vertebroplasty has significant efficacy for elderly female patients with OVCFs, which can reduce the incidence of bone cement penetration, and postoperative height of the injured vertebrae as well as effect of function recovery are better than that of low viscosity bone cement vertebroplasty.