Objective To observe the correlation between the dosimetric constraints for pelvic bone marrow (PBM) and the occurrence of acute myelosuppression in elderly patients with cervical cancer undergoing pelvic volumetric modulated arc therapy (VMAT), and to provide reference for clinical determination of the dose/volume parameter standards of PBM sparing. Methods A retrospective analysis was performed on 76 elderly patients with cervical cancer who were treated in Qingdao Central Hospital from January 2016 to January 2020. They were classified into stage IB to IVA with International Federation of Gynecology and Obstetrics (FIGO) staging system and all received VMAT treatment. According to whether PBM sparing was performed (pelvic bone dose/volume parameters V20≤70%, V30≤50%, Vx refers to the volume of the pelvis receiving a dose ≥ xGy), they were divided into PBM sparing group (n=35) and non-PBM sparing group (n=41). SPSS statistics 22.0 was used for data analysis. Student′s t test, rank sum test or Chi-square test was used for comparison between groups depending on the data type. Results The incidence of myelosuppression with leukopenia≥grade 2 was significantly lower in the PBM sparing group (68.6%, 24/35) than the non-PBM sparing group (87.8%, 36/41, P=0.042). So was the incidence of neutropenia≥grade 2 in the 2 groups [45.7% (16/35) vs 70.7% (29/41), P=0.028]. There were no statistical differences in the conformity index (0.835±0.059 vs 0.854±0.072) and homogeneity index (0.090±0.005 vs 0.086±0.005) between the 2 groups (P>0.05). Conclusion PBM dosimetric constraints with V20≤70% and V30≤50% can significantly reduce the incidence of myelosuppression≥grade 2 in elderly patients with cervical cancer, and show no effect on the target volume dose conformity and homogeneity. V20≤70% and V30≤50% can be used as the dose/volume standards of PBM dosimetric constraints.