Abstract: Objective This study aimed to observe the effect of Gusongbao Granules in the intervention of elderly patients with osteoporotic vertebral compression fracture（OVCF）. Methods Elderly patients with OVCF admitted to the Liaocheng Hospital of Traditional Chinese Medicine from June 2021 to June 2024 were included as the research subjects and grouped by the random number table method. The control group（57 cases） was treated with calcium carbonate D3 granules and elcitonin, while the observation group（56 cases）was given Gusongbao Granules on the basis of calcium carbonate D3 granules and elcitonin. The therapeutic effects of the two groups were observed. Results The total effective rate of treatment in the observation group was higher than that in the control group（P ＜ 0.05）. The visual analogue scale（VAS） for pain, interleukin-6 level, beta C-terminal cross-linked telopeptides of type I collagen（β-CTX）, vertebral height, Cobb Angle, bone mineral density T value and Oswestry disability index（ODI） were compared. The intergroup effect was significant（two-sided P ＜ 0.05）, and the time effect was significant（two-sided P ＜ 0.05）. The group-by-time interaction was statistically significant（two-sided P ＜ 0.05）. The levels of tumor necrosis factor-alpha（TNF-α） were compared. The results showed that the intergroup effect was not significant（two-sided P ＞ 0.05）, and the time effect was significant（two-sided P ＜ 0.05）, with no statistically significant group-bytime interaction（two-sided P ＞ 0.05）. The levels of N-terminal propeptide of serum type 1 procollagen（P1NP） were compared, finding that the intergroup effect was not significant（two-sided P ＞ 0.05）, the time effect was significant（two-sided P ＜ 0.05）, and the group-by-time interaction was statistically significant（two-sided P＜0.05）. There was no difference in safety indicators between the two groups（P＞0.05）. Conclusion Gusongbao granules effectively alleviate pain, reduce inflammation, improve vertebral metrics, inhibit bone resorption, and enhance bone density in elderly OVCF patients, with a favorable safety profile.