OBJECTIVE: To compare the curative effects of two unilateral puncturation percutaneous vertebroplasty (PVP) for the pain caused by multiple-level osteoporotic vertebral body compression fractures (OVCF) in senile patients. PATIENTS AND METHODS: From June 2008 to November 2014, eighty-nine cases suffering from fresh multiple-level OVCF were randomly divided into experimental group (n=51) and control group (n=38). Patients underwent PVP guided by C-arm fluoroscopy in the prone position. We monitored and recorded the visual analgesic scale (VAS) at pre-operation and 2 days post-operation, operation time, exposure duration, bone cement injection amount and extraosseous cement leakages. RESULTS: PVP procedures were successful in both groups without serious complications. The VAS scores in both two groups at 2 days post-operation were significantly lower than VAS scores at pre-operation (p<0.05). The operation time and exposure duration in the observational group were significantly lower than those in the control group (p0.05). CONCLUSIONS: The curative effects of two unilateral puncturation PVPs were satisfactory. However, puncturation method had lower operation time and lower X-ray exposure dose. We concluded that puncturation method was a suitable method to be considered for clinical application.