The paraspinal muscle fat infiltration and osteoporotic vertebral compression fractures (OVCFs) are common degenerative diseases of the skeletal muscle system in the elderly population, which seriously affect the quality of life. In recent years, many studies have focused on the relationship between paraspinal muscle fat infiltration and common lumbar diseases. However, the impact of this extrinsic factor on the progression of OVCFs has not yet received sufficient attention in clinical practice. This article summarizes the imaging characteristics and clinical relevance of paraspinal muscle fat infiltration in OVCFs, aiming to provide some ideas for the prevention, treatment, and related research of OVCFs and paraspinal muscle fat infiltration.