Objective To assess the efficacy and safety of posterior reduction and short pedicle screw fixation at fracture level (method A) for treatment of single level compress thoracolumbar fractures. Methods The clinical data of 87 patients with single level compress thoracolumbar fractures, who were surgically treated between January 2010 and January 2012 in our hospital, were retrospectively analyzed. treated by posterior. The patients were divided into two groups according to surgical methods. Group A: Patients were treated with method A; Group B: Patients were treated by conventional posterior decompression, redultion of fracture and short segment fusion and internal fixation. The operation time and intraoperative blood loss were recorded and the postoperative pain was evaluated. The adjacent vertebral Cobb angle and the anterior height of the injured vertebra on the lateral radiographs were measured before surgery, immediately after surgery, and 1 year after surgery, and the vertebral compression ratio was calculated. Results Among the 73 patients who were finally included in the study, 38 were in group A and 35 in group B. There were no significant differences in patient age, compression ratio, Cobb angle before or after surgery between the two groups. The operation time in group A was signficantly longer than that in group B(121 min vs 92 min,P<0.05); the compression ratios immediately and 1 year after surgery in group A were significantly higher than those in group B ([immediately after surgery: 91.3% (82%-93%) vs 77.2% (73%-86%), P<0.05; 1 year after sugtery: 87.2% (79%-93%) vs 73.1%(68%-80%),P<0.05]). The Cobb angle at 1 year after operation in group A was significantly smaller than that in group B (7.8°[0°-15°] vs 11°[2°-17°],P<0.05). There was no significant differences in blood loss or scores of low back pain between the two groups. Conclusion Posterior reduction and short pedicle screw fixation can safely and effectively reconstruct the vertebral body height and correct kyphosis in patients with single level compress thoracolumbar fractures.