Objective To explore the postoperative quality of life and its influencing factors in elderly female patients with osteoporotic vertebral compression fractures (OVCF). Methods A cross-sectional study was conducted on 173 elderly female OVCF patients undergoing surgical treatment in our medical center from December 2020 to June 2023. The enrolled patients were given questionnaires and instructed to fill them out, which included three parts, that is, general data, fracture and treatment, and quality of life. SPSS statistics 23.0 was used for data processing, and student′s t test or Chi-square test was performed depending on data type. Multivariate linear regression analysis was employed to identify the related factors of postoperative quality of life in elderly female patients with OVCF. Results The scores of physical function, pain, role physical, general health status, energy, psychological state and social function of 36-item short-form health survey (SF-36) were significantly lower in elderly female OVCF patients after surgery than the domestic norms (P<0.05). Marital status (β=-0.168, P=0.036), average monthly family income (β=0.273, P=0.019), bone mineral density (β=0.152, P<0.001) and anti-osteoporosis therapy (β=0.367, P=0.004) were the influencing factors of postopera-tive quality of life in elderly female patients with OVCF (P<0.05). Conclusion The quality of life is quite poor in elderly female patients with OVCF after surgery, and marital status, average monthly family income, bone mineral density and anti-osteoporosis therapy are related factors affecting their quality of life.