[Objective] To study the clinical efficacy of posterior pedicle screw fixation combined with transpedicular intracorporeal grafting in the treatment of A3 thoracolumbar fractures. [Methods] Retrospective analysis the clinical and imaging data of 58 cases with A3 thoracolumbar fractures treated with posterior pedicle screw fixation combined with transpedicular intracorporeal grafting in our department between Jan 2013 to Jan 2016.[Results] All 58 patients were followed up. The average operating time was 71.51±23.51min. The average blood loss was 82.17±33.80 ml. The average length of stay was 13.61±3.74 days. The incidence of complications was 13.8％. VAS, ODI, FIM and improved Macnab efficacy evaluation criteria were significantly improved （P ＜0.0001）. The anterior height, middle height and Cobb angle of vertebral body were significantly improved （P ＜ 0.0001）. [Conclusion] Posterior pedicle screw fixation combined with transpedicular intracorporeal grafting treating A3 thoracolumbar fractures, can effectively relieve pain, restore vertebral height, correct kyphosis, and improve the standard of living.