[Objective] To investigate the effect of orthopedic robot-assisted extrapedicle approach for the treatment of osteoporotic vertebral compression fractures. [Methods] A total of 43 clinical data of vertebroplasty by uni-extrapedicle approach for osteoporotic vertebral compression fractures from March 2019 to March 2022 were retrospectively analyzed. According to the results of doctor-patient communication, 18 patients belonged to the robot group and 25 to the fluoroscopy group. The perioperative, follow-up and imaging data of the two groups were compared and analyzed. [Results] The operation time of the robot group was longer than that of the fluoroscopy group (P< 0.05). The number of fluoroscopy in the human group was smaller than that in the fluoroscopy group (P< 0.05). There were no significant differences in walking time, puncture success rate, bone cement leakage rate and hospitalization days between the two groups (P> 0.05). The mean follow-up time was (19.8±5.7) months. There were no significant differences in VAS score and ODI score between the two groups before surgery, 3 days after surgery, 3 months after surgery and at the last follow-up (P> 0.05). There was no significant difference in the excellence rate of bone cement distribution (P> 0.05). There were no significant differences in the Cobb Angle of local kyphosis and the height of vertebral anterior margin between the two groups at preoperative, postoperative and last follow-up (P> 0.05). [ Conclusion] Robotic navigation can reduce the number of fluoroscopy, but increase the surgical time, and can be a useful supplement to current surgical methods.