It is the aim of this study to investigate the influence of the age of vertebral fractures on the clinical and radiological outcome of balloon kyphoplasty. All data were recorded prospectively at each visit (admission, postoperatively, discharge) and no patient was lost. 92 Patients (27 male, 65 female, mean age 67,2 years, mean body mass index 26,4) with 102 vertebral fractures (84 patients had one fracture, six had two and two had three fractures) were included in this study. All fractures were type A of the AO-classification (29 were A1.1, 34 were A1.2, 36 were A1.3, 2 were A3.1 and one was A2.3). Radiologically verebral body height, kyphosis angle, kyphosis index, compression index and bone cement application were evaluated. Clinically pain intensity (VAS 0-10), pain medication consumption (WHO 1-3) and surgical specific data were documented. The age of the vertebral body fracture was less than one week in 23 patients, between 7 and 14 days in 22 patients and more than 14 days in 57 patients. The mean surgical time was 43 minutes with a mean cement volume of 3,3 ml. A significant reduction of the kyphosis angle and index and an increase of the verebral body height could be documented. Pain medication consumption was reduced from 1,8±0,9 preoperatively to 1,2±1,1 at discharge. A significat reduction of pain intensity was observed (8,2±1 preoperatively vs. 3,9±2,5 at discharge). The most intense pain reduction at discharge was seen in fresh fractures (ifracture age < 7 days 2,4±0,5, 7–14 days 4,0±0,6, > 14 days 4,4±0,3; p< 0,005). Balloon kyphoplasty is a reliable method to reduce vertebral body fractures. A pain reduction can be achieved in all cases, but pain is mot effectively reduced in fresh treated fractures.