Abstract: Objective To compare the clinical efficacy of percutaneous pedicle screw fixation and traditional open surgery for the treatment of single segment thoracolumbar vertebral fractures. Methods A total of 30 patients who received pedicle screw fixation due to thoracolumbar fractures from October 2014 to October 2016 were selected, including 15 patients in a traditional open surgery group and 15 patients in a percutaneous pedicle screw fixation group. Then, both groups were compared for intraoperative parameters, imaging indicators (blood loss, the length of hospitalization stay and the duration of surgery) and visual analogue scale (VAS) scores. Results No statistical difference was found as to the duration of surgery between the two groups (P>0.05), but significant differences were found in intraoperative blood loss and the length of hospitalization stay (P<0.01). There was no statistical difference in VAS score between the two groups before and three months after surgery (P<0.05). The VAS score was 1.91±0.27 and 1.55±0.19 in the percutaneous pedicle fixation group one week and one month after surgery, which was remarkably lower than those in the traditional open surgery group (2.81±0.37 and 2.31±0.30, P<0.01). The radiographic vertebral height and Kyphosis Cobb angle were recovered obviously after surgery, but no significant differences were found between the two groups immediately, half of a year and one year after surgery (P＞0.05). Conclusions Percutaneous pedicle screw fixation is characterized in small incision, little blood loss and postoperative pain and fast recovery, which is effective to be applied in thoracolumbar fractures.