Percutaneous vertebroplasty (PVP) has played an increasing role in the treatment of osteoporotic compression fracture. The number of prior vertebral fractures and prior vertebroplasties are important risk factors for future fractures. We prospectively evaluated the effectiveness of teriparatide therapy for 28 patients who had repeated and multiple new-onset vertebral compression fractures (VCF). None of the patients required PVP or experienced a new-onset vertebral fracture during the treatment and follow-up period of at least 18 months. Teriparatide therapy significantly decreased visual analogue scale pain scores, increased Japanese Orthopaedic Association function scores, increased spinal bone mineral density, and prevented new-onset VCF. Teriparatide can be used in patients who have repeated and multiple new-onset painful VCF to avoid repeated vertebroplasty. Therapy should continue for at least six months to ensure it is effective.