20 studies (6 randomized controlled trials and 14 prospective controlled trials) were included in this meta-analysis comparing the safety and efficacy of percutaneous kyphoplasty versus vertebroplasty in patients with osteoporotic vertebral compression fractures. The purpose of this study was to compare treatment options with respect to short- and long-term postoperative pain, anterior vertebral body height, Cobb angle, and rate of adverse events such as cement leakage and adjacent fractures. The results of this meta-analysis indicated that postoperative pain relief was comparable between the two procedures, but a greater incidence of cement leakage was observed in patients who received percutaneous vertebroplasty. Radiographic results of Cobb angle, particularly over the long-term, and vertebral height also favoured percutaneous kyphoplasty.