Objective: The characteristics and risk factors of bone cement leakage after vertebroplasty in elderly patients with Kümmell’s disease were analyzed. Methods: The data of 106 elderly patients with Kümmell's disease (134 vertebrae) treated with vertebroplasty from May 2018 to May 2021 were retrospectively analyzed, and the occurrence of bone cement leakage was counted, and divide the patients into leaky group and non-leaky group, the characteristics of bone cement leakage of the patients were analyzed, and the clinical characteristics of patients in the leakage group and the non-leakage group were compared. Logistic regression was used to analyze the risk factors of bone cement leakage after vertebroplasty in elderly patients with Kümmell’s disease. Results: Among 106 elderly patients with Kümmell’s disease treated with vertebroplasty (134 vertebrae), 43 cases (56 vertebrae) suffered bone cement leakage, and the leakage rate was 40.57% (43/106). Among the types of vertebral body injury, the incidence of bone cement leakage after vertebral body injury were higher in vertebral body fissures and fissure signs + cortical bone injury, In the distribution of leakage characteristics, the three types of vertebral body injury have the highest incidence of paravertebral leakage, followed by intervertebral disc leakage, and the lowest incidence of intraspinal canal leakage. Compared with patients in the non-leakage group, there were no statistically significant difference in the composition ratio of the gender, age, degree of fracture, fracture shape, cortical bone protruding into the posterior spinal canal, vertebral base venous foramen, number of vertebral injuries, preoperative height of injured vertebrae, preoperative Cobb angle, puncture method of patients in the leakage group (P>0.05), the Kümmell’s disease stage, fracture location, bone cement shape, bone cement amount, vertebral injury type of patients in the leakage group were compared with those in the non-leak group, and the differences were statistically significant (P<0.05). Logistic multivariate regression analysis showed that fracture location, bone cement shape, amount of bone cement, and type of vertebral body injury were all independent risk factors affecting bone cement leakage after vertebroplasty in elderly patients with Kümmell’s disease (P<0.05). Conclusion: Vertebral fissures and fissure signs + cortical bone injury types have a higher incidence of postoperative leakage after vertebral injury, and the main reason is paravertebral leakage, fracture location, bone cement shape, amount of bone cement, and type of vertebral body injury are all independent risk factors affecting bone cement leakage after vertebroplasty in elderly patients with Kümmell’s disease, and clinical prevention should be strengthened.