[Objective] To investigate the clinical outcomes of percutaneous vertebroplasty (PVP) for severe osteoporotic vertebral com- pression fractures (sOVCF) . [Methods] A retrospective study was conducted on 39 patients who received PVP for sOVCF in our hospital from September 2018 to December 2020. The clinical and radiological data were evaluated. [Results] All patients were successfully operat- ed on with the mean operation time of (56.3±5.7) min and the mean bone cement injected of (5.2±2.2) ml. Bone cement leakage occurred in 9 cases (23.1%) , including paravertebral leakage in 3 cases and intervertebral leakage in 6 cases, all of which had no obvious clinical symptoms. All the patients were followed up for a mean of (12.7±3.8) months. With time elapsed preoperatively, 2 days postoperatively and the latest follow up, the VAS score [(6.5±0.2) , (2.4±0.8) , (2.5±0.8) , P＜0.05] and ODI score [(77.9±4.4) , (24.2±2.9) , (24.7±3.4) , P＜0.05] significantly reduced, while the JOA score [(14.3±2.7) , (21.3±1.9) , (20.7±1.7) , P＜0.05] significantly increased. Radiographically, the in- jured vertebral height [(6.7±1.7) mm, (16.5±4.0) mm, (14.4±3.3) mm, P＜0.05] increased significantly, while the local kyphotic Cobb angle [(24.1±13.0)°, (15.6±10.2)°, (19.0±1.5)°, P＜0.05] decreased significantly. [Conclusion] The PVP is safe and effective in the treatment of sOVCF. Preoperative position reduction and full filling of injured vertebral fissure are the key to successful treatment.