Abstract：Objective：To observe the clinical effect of Xianling Gubao capsules combined with routine western medicine for senile osteoporosis and its effect on bone metabolism markers. Methods： The clinical data of 102 senile patients with osteoporosis were retrospectively selected. According to their treatment methods in the data，the patients were divided into the control group and the observation group，with 51 cases in each group. Both groups were given routine anti-osteoporosis treatment； the control group was additionally given intramuscular injection with salmon calcitonin injection， and the observation group was additionally given oral administration of Xianling Gubao capsules based on the treatment of the control group. The clinical effects in the two groups were compared. Before and after treatment， Chinese medicine syndrome scores， bone mineral density values， bone metabolism markers and incidences of adverse reactions were observed. Results：The total effective rate was 92.16% in the observation group，higher than that of 82.35% in the control group，the difference being significant(P＜0.05). After treatment，Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P＜0.05)，and the scores in the observation group were lower than those in the control group(P＜0.05). After treatment，the values of L2～4 vertebrae and left femur intertrochanteric bone mineral density in the two groups were increased when compared with those before treatment(P＜0.05)， and the above values in the observation group were increased when compared with those in the control group(P＜0.05). After treatment，the levels of β- C- terminal telopeptide of type Ⅰcollagen(β- CTX) and amino- terminal propeptide of type Ⅰprocollagen(PINP) in the two groups were decreased when compared with those before treatment，and the levels of 25-hydroxy vitamin D(25-OHD) and N- terminal molecular fragments of osteocalcin(N- MID) were increased(P＜0.05)； the levels of β- CTX and PINP in the observation group were lower than those in the control group，and the levels of 25-OHD and N-MID were higher(P＜0.05). The incidence of adverse reactions was 5.88% in the observation group，lower than that of 15.69% in the control group，the difference being significant(P＜0.05). Conclusion： Xianling Gubao capsules combined with routine western medicine for senile osteoporosis has a significant curative effect， and can improve clinical symptoms， bone mineral density and bone metabolism markers，and reduce the incidence of adverse reactions，which is safe and reliable.