[objective] To compare the clinical outcomes of opening pedicle subtraction osteotomy(oPSO) and posterior subtotal vertebral resection（PSVR） in the treatment of old thoracolumbar fractures with kyphosis.[Methods] From April 2013 to January 2018, we retrospectively studied 36 patients who received surgical treatment for old thoracolumbar fractures with kyphosis in our hospital.Among them, 20 patients who received operation of opening pedicle subtraction osteotomy were named as the oPSO group,whereas the remaining 16 patients who received operation of posterior subtotal vertebral resection were named as the PSVR group. There were was no significant difference between two groups in gender，age，injury site, FRANK classification, course of disease, cobb angle, intervertebral height, clinical score. Operation time,intraoperative blood loss, complications of perioperative period , ODI,JOA, cobb angle and the intervertebral height of different time periods were recorded and compared between two groups. [Results] There was a significant difference in operation time and intraoperative blood loss between the two groups (P < 0.05). In both groups，the ODI and JOA scores of the last follow-up wasere significantly improved compared with preoperation(P＜0.05). Cobb angle and intervertebral height of post-operation and the last follow-up were significantly improved compared with preoperation(P＜0.05), which indicated that the quality of life and function of those patients recovered well after the operation, and the effect was maintained well. There were no significant difference in follow-up indexes between the two groups during the same period (P > 0.05). [Conclusion] Both oPSO and PSVR can achieve satisfactory correction and clinical results in the treatment of old thoracolumbar fractures with kyphosis. The intraoperative trauma, intraoperative blood loss and operation time of oPSO are significantly smaller than PSVR’s.