Forty-eight patients over 50 years old with acute pelvic fractures were randomized to receive abaloparatide (n=24) or placebo (n=24). The primary outcome of interest was fracture healing, assessed via CT imaging using a blinded 5-point cortical bridging scale. Secondary outcomes included pain reduction (measured monthly via numeric rating scale) and functional mobility (assessed monthly using the Short Physical Performance Battery). Outcomes were assessed at 3 months. Overall, abaloparatide demonstrated a trend toward improved radiographic healing (p=0.09), with a significant benefit in patients with displaced fractures (p=0.002). Pain reduction was greater in the abaloparatide group at 4 weeks (p=0.04), but there was no significant difference in functional mobility between groups. These findings suggest abaloparatide may enhance fracture healing, particularly in displaced fractures, and may accelerate early pain reduction.