〔Abstract〕Objective To study and analyze the clinical effects of percutaneous balloon kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) in the treatment of elderly patients with spinal compression fractures. Methods 90 elderly patients with spinal compression fractures treated in Guizhou Aerospace Hospital from June 2018 to March 2019 were randomly divided into control group and observation group, with 45 cases in each group. PVP was used in the control group and PKP was used in the observation group. After treatment, the pain score, mental state score, life ability score, spinal function score and treatment effectiveness were compared between the two groups. Results After treatment, the pain score, mental state score, life ability score and vertebral body height of the observation group were significantly better than those of the control group (P < 0.05); After treatment, the Cobb angle in the observation group was significantly smaller than that before treatment and that in the control group after treatment (P < 0.05); The total effective rate of the observation group was 97.8%, which was significantly higher than 82.2% of the control group (P < 0.05); The leakage rate of bone cement in the observation group was 0.00%, which was statistically significant compared with 11.11% in the control group (P < 0.05). Conclusion Compared with PVP in the treatment of elderly patients with spinal compression fractures, PKP has a more significant effect. It can not only effectively improve the pain and quality of life of patients, but also significantly improve the clinical treatment effect, reduce the leakage rate of bone cement, promote the recovery of vertebral body height and correct kyphosis. At the same time, PKP is more safe and reliable.