Background: The study aimed to evaluate the clinical efficacy and safety of minimally invasive approach for painful spinal osteoblastic metastases by percutaneous kyphoplasty (PKP).Methods: A total of 30 patients (11 males and 19 females, average age, 58.9 ± 8.7 years) with 56 spinal osteoblastic lesions underwent PKP under conscious sedation were reviewed retrospectively. Visual analogue scale (VAS) score was employed to assess pain. Karnofsky performance score (KPS), quality of life (QOL) score (short form with 36 questions) and related complications were used to evaluate the clinical outcomes of the procedures.Results: All patients underwent PKP successfully and the pain was significantly alleviated after PKP. Mean VAS scores decreased significantly from 6.07 ± 1.84 preoperatively to 2.70 ± 1.56 at 3 days after PKP (P<0.001), and remained largely immutable at 1 month (2.03 ± 0.72; 30 patients; P<0.001), 3 months (2.38 ± 1.24; 29 patients; P<0.001) and 1 year (3.04 ± 1.00; 26 patients; P<0.001). Mean KPS and QOL scores were 59.33 ± 19.11 and 91.20 ± 12.88 preoperatively and improved to 69.31 ± 19.81 (P < 0.001) and 99.61 ± 12.29 (P < 0.001) at 3 months after PKP, respectively. Two (6.7%) patients suffered from the leakage of bone cement.Conclusions: As a minimally invasive surgery, PKP may not only effectively allevated the pain, but also safely improved the QOL of spinal osteoblastic metastatic patients.