Acute vertebral fracture is a painful and debilitating complication of osteoporosis which has been extremely difficult to manage. Percutaneous vertebroplasty--injecting cement to stabilise the fractured end plate--represents a major management breakthrough. We report the first four patients with osteoporotic vertebral fractures treated by this technique at our hospital. They are, to our knowledge, among the first to be successfully treated in this way in Australia.