Background. Vertebral osteoporotic fractures are a worldwide problem and can cause significant morbidity. Material and methods. retrospective analysis reviewing functional outcome of 70 patients who underwent balloon-kyphoplasty(BK). Inclusion criteria, a-patients above 60 years of age b-symptomatic patients who failed conservative treatment c-radiological diagnosis of vertebral compression fracture(VCF). Primary outcome was evaluation of functional outcome in mid- (1-3 years) and long term (>3 years). Secondary outcomes a-analysis of the functional outcome of patients with severe disability or worse in mid- and long-term b-comparison of functional outcome between mid-term and long term follow-up c-correlate number of levels operated on with functional outcome. Results: There were 70 patients with average age of 74 years. Lumbar and thoracic VCFs were included. Average follow-up was 2.7 years. Twenty-eight patients had long-term follow-up of ≥ 3 years and the remaining 42 had mid-term follow-up of > 1 year and < 3 years. All patients experienced clinical and statistically significant improvement in their Oswestry Disability Index score. This was the case in mid-term and long-term follow-up. This was also the case for patients presenting with severe disability. There was no correlation between the number of levels and functional outcome. Conclusions. 1. Osteoporotic vertebral compression fractures are fragility fractures and can be associated with significant morbidity. 2. Surgical treatment can help improve functional outcome on failure of conservative treatment. 3. Balloon kyphoplasty can significantly improve pa­tients’ functional outcome in mid-term and long-term follow-up including patients presenting with severe disability or worse. 4. This study is of value in consenting kyphoplasty patients as they can expect an improvement in their disability in the mid-to-long term