The incidence of acute symptomatic thoracolumbar vertebral osteoporotic fracture is high. Improper early treatment can seriously affect the quality of patients’life, and significantly increase social and family burden. At present, there are many types of fracture classification for acute symptomatic thoracolumbar vertebral osteoporotic fractures. However, most types of fracture classification cannot guide clinical treatment very well, which results in random and confused treatment in clinic work. Therefore, the author describes the diagnosis, classification and corresponding treatment of acute symptomatic thoracolumbar vertebral osteoporotic fractures in order to provide reference for clinical selection of treatment methods.