[Objective] To evaluate the clinical outcomes of posterior column osteotomy (PCO) combined with local multi-level transfo- raminal lumbar interbody fusion (TLIF) in the treatment of degenerative scoliokyphosis. [Methods] A retrospective study was performed on 71 patients who received surgical treatment for degenerative spine deformity in our hospital from January 2018 to June 2021. Based on preop- erative doctor-patient communication, 40 patients received PCO combined with local mutipl-level TLIF (PCO-MF group) , while the re- maining 31 patients received grade ≥3 osteotomy and fixation (OF group) . The documents regarding perioperative conditions, follow-up and radiographs were compared between the two groups. [Results] The incidence of early complications was of 7.5% (3/40) in the PCO- MF group, whereas 25.8% (8/31) in the OF group, which was statistically significant (P=0.034) . The PCO-MF group proved significantly superi- or to the OF group in terms of operative time, intraoperative blood loss, postoperative walking time and full weight-bearing activity time (P＜ 0.05) , although there were no significant differences in the total incision length, intraoperative fluoroscopy times, incision healing and hospi- tal stay between the two groups (P＞0.05) . With time of follow-up for more than 12 months, the VAS and ODI scores significantly decreased (P＜0.05) , while JOA score significantly increased in both groups (P＜0.05) , which in the PCO-MF group was significantly better than those in the OF group at discharge (P＜0.05) . Radiographically, the main curved coronal Cobb angle, sagittal Cobb angle, coronal balance and sag- ittal balance significantly improved in both groups immediately after surgery and at the latest follow-up compared with those preoperatively (P＜0.05) , nevertheless no significant differences in the above image parameters were noted between the two groups at any time point accord- ingly (P＞0.05) . At the latest follow-up, non-patient in both groups had adverse imaging manifestations such as loosening and fracture of the implants. [Conclusion] PCO combined with local multi-level TLIF is an effective treatment for degenerative spinal deformity, and does re- duce surgical trauma, reduce surgical risk, accelerate postoperative rehabilitation, and reduce complications.