Abstract: Objective To investigate the influences of manual reduction combined with percutaneous vertebroplasty on vertebral body height and pain in vertebral fracture senile osteoporosis patients with vertebral fracture. Methods Totally 195 senile osteoporosis patients with severe vertebral fracture admitted to our department from July 2013 to April 2016 were randomly divided into two groups with 98 cases in research group and 97 cases in control group, and both of the two groups underwent percutaneous vertebroplasty (PVP). Before surgery, the research group were treated with manual reduction, and the improvement of vertebral height and pain level of the two groups were recorded. Results One week after surgery, the heights of anterior, midline and posterior edge of the injured vertebra in the research group were higher than those of control group (23.97±1.27) mm vs (22.33±1.39) mm, (26.61±1.37) mm vs (24.83±1.08) mm, (24.17±0.75) mm vs (27.34±1.52) mm, P< 0.05, respectively. VAS scores of all the patients before operation, at 1 weeks, 3 months and 12 months after operation in research group and the control group were (6.28±0.56) vs (6.34±0.58), (2.53±0.33) vs (3.18±0.49), (1.34±0.23) vs (2.72±0.40), (1.09±0.18) vs (1.87±0.25) (All P> 0.05).After operation, VAS scores of both of the two groups decreased significantly, and the research group was significantly lower than that of the control group (P< 0.05). Conclusion The manual reduction combined with percutaneous vertebroplasty has obvious clinical effect in senile osteoporotic vertebral fracture.