Percutaneous vertebroplasty and kyphoplasty provide minimally invasive options for the management of osteoporotic and osteolytic vertebral compression fractures. These techniques provide substantial pain relief and support without requiring long periods of recumbency, and have an acceptable complication rate. Vertebral augmentation techniques such as vertebroplasty and kyphoplasty provide pain relief and improvement in quality of life in the highly selected patient. Complications can be avoided with careful surgical technique, and good outcomes can be achieved with proper patient selection.