Osteoporotic vertebral compression fractures are increasing in prevalence as the general population ages. The consequences of these fragility fractures are significant and include pain, impaired normal physical functioning, decreased lung capacity, kyphosis of the spine, loss of appetite, depression, and increased mortality. Early aggressive treatment of these fractures can prevent the ripple effect of morbidity associated with these fractures. Prevention and treatment of the underlying osteoporosis forms the foundation of the treatment paradigm for these fractures. A review of epidemiology, consequences, diagnosis, and treatment options for osteoporotic vertebral compression fractures is presented.