To evaluate the effectiveness and safety of Chinese herbal medicine for primary osteoporosis by meta analysis. Methods:Randomized controlled clinical trials were searched from Pub Med, Cochrane, EMBASE, BioMed Central, VIP, CNKI, Sino-Med, Wanfang database. Two researchers assessed eligible data and extracted relevant elements independently according to the standards of Cochrane center. Then effective data and quality were analyzed by RevMan 5.3 Software. Results:A total of 23 randomized control clinical trials involving 1971 osteoporosis patients with pain were included.Traditional Chinese Medicine group (TCM) were compared with the control group, and significant difference between VAS（Visual Analogue Scale/Score）scores［WMD＝-1.06，95%CI (-1.49,-0.63), P<0.00001］ and BMD (Bone mineral density) of lumbar spine ［(Weighted Mean Difference)WMD=0.08，95%CI (0.02，0.13), P=0.005］ in short-term were found.Compared with the control group, VAS scores of short and medium term［WMD＝-1.70，95%CI (-2.18,-1.21)，P<0.00001］, ［WMD＝-0.95，95%CI (-1.47,-0.43)，P=0.0003］ could be significantly reduced in TCM combined with control group, and the level of BMD has statistical difference in medium term. There was no statistical difference in adverse reactions between the two groups ［WMD＝-0.21，95%CI (-0.43，0.01), P=0.06］. Conclusion:Chinese herbal medicine could effectively alleviated low back pain from primary osteoporosis in early stage, and improved the BMD of the lumbar spine. At the same time, there was little adverse reaction. So it can be taken as a effective and safe intervention for the treatment of osteoporosis with low back pain.