〔Abstract〕 Objective To explore the curative effect and adverse reaction analysis of Bushen Jianpi decoction in treating primary osteoporosis. Methods A total of 80 patients with primary osteoporosis admitted to Nanyang Hospital of Traditional Chinese Medicine from March 2020 to December 2021 were selected and divided into a control group and an observation group with 40 cases in each group by random number table method. The control group received western medicine treatment, and the observation group received Bushen Jianpi decoction. The therapeutic efficacy, bone density, bone biochemical indexes and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was 95.00 %, which was higher than 80.00 % of the control group, and the difference was statistically significant (P < 0.05). After treatment, the bone density of trigone, trochanter, neck of femur and lumbar vertebra in observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the levels of blood calcium/blood creatinine and serum alkaline phosphatase in the observation group were lower than those in the control group, and the level of serum calcium in the observation group was higher than that in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Bushen Jianpi decoction in the treatment of primary osteoporosis, can better improve the bone density, bone biochemical indexes, enhance the curative effect on the basis of strict control of adverse drug reactions.