Objective： To investigate the effect of Yishen-Buganjiangu decoction combined with ecalcitonin on primary osteoporosis and its influence on bone metabolism and oxidative stress. Methods: Eighty patients with osteoporosis were divided into a control group and an observation group. The control group received intramuscular injection of ecalcitonin, 10 IU·time-1, twice a week. The observation group was treated with Yishen Bugan Jiangu decoction on the basis of the control group. Both groups were treated for 6 months. The curative effect, bone mineral density, bone pain [visual analogue scale (VAS)], bone metabolism index [procollagen type Ⅰ N-terminal propeptide (PINP), type I C-terminal cross linked peptide (CTX-1), serum oxidative stress markers [malondialdehyde (MDA) and advanced oxidation protein product (AOPP)]before and after treatment were compared between the two groups. Results: After treatment, the total effective rate of the observation group was higher than that of the control group (97.50% vs 82.50%, P<0.05), and the VAS score was lower than that of the control group (P<0.05). After treatment, PINP increased in the two groups (P<0.05), and it was higher in the observation group (P<0.05). The levels of CTX-1 in the two groups were decreased (P<0.05), and the level in the observation group was lower (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Yishen Bugan Jiangu Decoction combined with western medicine is effective in the treatment of primary osteoporosis, which can improve bone metabolism and oxidative stress.