This study aimed to investigate the application valuable of percutaneous vertebroplasty (PVP) with unilateral multiple channels approach in osteoporotic vertebral fractures patients. A retrospective review was conducted on 685 consecutive patients with osteoporotic vertebral fracture from March 2003 to October 2012. Among them, 82 cases were given PVP procedure by unilateral multiple channels approach. The timing of surgery, bone cements injection, and complications were analyzed. By using the X-ray film, the distribution of cement was detected and scored. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function after operation. The excellent and good rate of cement distribution was 98.8% (98/99). Before surgery, the VAS score was 2.5 +/- 0.43. After surgery, the VAS score was significantly decreased to 2.0 +/- 0.33 at 1 h. Before surgery, ODI was 40.94 +/- 2.72. ODI was significantly decreased at 1 month after surgery (9.64 +/- 2.60) and at the final follow-up (7.77 +/- 2.15). No spine or nerve injury, bone cement leakage, pulmonary embolism, pneumothorax, bleeding or infection occurred intraoperatively. Thus, the PVP with unilateral multiple channels approach effectively relieve the pain and improve the functional activity, without occurrence of complications.