[Objective] To investigate the current status of psychological resilience and its influencing factors in elderly patients with osteoporotic vertebral compression fractures. [Methods] A total of 61 elderly patients with osteoporotic vertebral compression fractures,receiving medical bone metabolism treatment at the endocrinology department of a tertiary hospital from April to May 2024,were selected. A self-designed questionnaire was used to collect general data,Connor-Davidson Resilience Scale,Pittsburgh Sleep Quality Index,Social Support Rating Scale, Barthel Index, and Visual Analog Scale data to assess psychological resilience. Multiple linear regression was used to analyze the influencing factors. [Results] The psychological resilience level of elderly patients with osteoporotic vertebral compression fractures was 63 (46,74). Univariate analysis showed statistically significant differences in psychological resilience based on education level,occupational status,per capita monthly income,caregiving situation,self-care ability,pain level,fracture condition, and social support level (P<0.05). Spearman correlation analysis indicated a positive correlation between psychological resilience and social support level (P<0.05). Multiple linear regression analysis revealed that education level (β=9.175,P<0.001) and social support (β=0.525,P<0.001) were independent influencing factors of psychological resilience. [Conclusion] The psychological resilience level of elderly patients with osteoporotic vertebral compression fractures is relatively low. Clinical work should emphasize psychological counseling and health guidance, particularly for patients with lower education levels and poorer social support,to enhance their coping beliefs and promote disease recovery.