Abstract： Objective： To observe the curative effect and effect mechanism of Ruxiang San for postmenopausal osteoporosis fracture (PMOPF). Methods： A total of 118 PMOPF patients were selected and divided into the control group and the study group according to the random number table method，with 59 patients in each group. Both groups underwent internal fixation surgery； the control group received routine drug treatment， and the study group received oral administration of Ruxiang San based on the treatment of the control group. The incidence of adverse reactions and the incidence of recurrent fractures during the follow-up period were compared between the two groups. The changes in Visual Analogue Scale (VAS) scores of pain， bone metabolism indexes [osteoprotegerin (OPG)， bone Gla protein (BGP)， bone alkaline phosphatase (BALP)，procollagen type Ⅰ N-propeptide (PⅠNP)，bone morphogenetic protein-2 (BMP-2)，carboxyterminal cross-linked telopeptides of type I collagen (CTX-I)，and tartrate-resistant acid phosphatase (TRACP)] and bone mineral density (BMD) were compared in the two groups before and after treatment. Results： The hospitalization time， first weight-bearing time， and fracture healing time in the study group were shorter than those in the control group，the difference being significant (P＜0.05). After 7 days， 1 month and 3 months of treatment， the VAS scores in the two groups were decreased when compared with those before treatment (P＜0.05)，and the VAS scores in the study group were lower than those in the control group (P＜0.05). After 3 months of treatment，the values of bone metabolism indexes including OPG，BGP，BALP，PⅠNP and BMP-2 in the two groups were increased when compared with those before treatment (P＜0.05)， and the CTX - Ⅰ and TRACP values were decreased when compared with those before treatment (P＜0.05)； the values of OPG， BGP， BALP， P ⅠNP， and BMP-2 in the study group were higher than those in the control group (P＜0.05)，and the values of CTX -Ⅰ and TRACP were lower than those in the control group (P＜0.05). After 3 months of treatment，the BMD index values of L1~4， total hip， and femoral neck in the two groups were increased when compared with those before treatment (P＜0.05)，and the above three BMD values in the study group were all higher than those in the control group (P＜0.05). During the medication period，neither group experienced liver and kidney function damage or abnormal electrocardiogram，and there was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). During the follow-up period， the incidence of recurrent fractures was 1.72% in the study group， and was 7.27% in the control group， there being no significant difference (P＞0.05). Conclusion： The treatment of Ruxiang San for PMOPF can alleviate pain， promote fracture healing，increase bone mineral density，and regulate bone metabolism.