ABSTRACT: Objective: To investigate the risk factors of adjacent vertebral re-fracture after osteoporotic vertebral compression fractures (OVCFs). Methods: 204 patients with OVCFs admitted to our hospital from February 2014 to January 2019 were divided into observation group (33 cases) and control group (171 cases) according to the occurrence of adjacent vertebral re-fracture after operation. Bone mineral density, excessive recovery of anterior vertebral height, low body mass index, past fracture history, Cobb angle, intervertebral disc leakage of bone cement, dose of bone cement and surgical approach were analyzed. The risk factors of adjacent vertebral re-fracture after OVCFs were determined by univariate and multivariate analysis. Results: Univariate and multivariate logistic regression analysis showed that bone mineral density, excessive recovery of anterior vertebral height, low body mass index, previous history of fracture, Cobb angle, intervertebral disc leakage of bone cement and dosage of bone cement were risk factors for adjacent vertebral re-fracture after OVCFs. CONCLUSION: All 204 patients were followed up for 6 to 12 months. Bone mineral density, excessive recovery of anterior vertebral height, low body mass index, previous fracture history, Cobb angle, leakage of intervertebral disc of bone cement and dosage of bone cement are risk factors of adjacent vertebral re-fracture after OVCFs. Risk factors should be paid attention to clinically, preventive treatment should be done well, and the occurrence of adjacent re-fracture should be prevented. Life.