The purpose of this study was to compare the efficacy of teriparatide (parathyroid hormone 1-34) alone and in combination with zoledronic acid (ZA) for the treatment of osteoporosis in postmenopausal women. Ninety-six patients were randomly equally divided into Groups A (n=48) and B (n=48). Group A was given parathyroid hormone 1-34 alone. Group B was treated with parathyroid hormone 1-34 plus ZA. Visual analogue scale (VAS) score, bone mineral density(BMD), serum osteopontin (OPN), and C-terminal cross-linking telopeptide of type I collagen (S-CTX) etc. were compared. After 6 months of treatment, VAS score, serum OPN and S-CTX levels in Group B were significantly lower than those in Group A (p=0.001, p<0.001 and p<0.001, respectively); and BMD values of lumbar vertebrae L2-4, femoral neck and total hip bone in Group B were higher than those of Group A (p=0.002, p=0.028 and p<0.001, respectively). In conclusion, parathyroid hormone 1-34 plus ZA is more effective than parathyroid hormone 1-34 alone in treating post postmenopausal osteoporosis. Key Words: Teriparatide (parathyroid hormone 1-34, Zoledronic acid (ZA), Postmenopausal, Osteoporosis, Bone mineral density (BMD).