Objective To observe the correlation between risk factors and symptoms of Chinese medicine (CM) in postmenopausal osteoporosis (OP) of females aged between 40 and 65. Methods Registry method was used in this study. Risk factors and information on symptoms of CM collected from 1 823 OP high risk females (40 -65 years old) in Dongcheng District of Beijing and Xuhui District of Shanghai (collected in our previous research). Meanwhile, Cox proportional hazard model was also a- dopted to conduct single-factor and multiple-factor analyses. Risk factors and symptoms of CM were screened and analyzed. Results A total of 1 498 subjects attended follow-up surveys, with the response rate of 82.17%. Of them, 52 had brittle fracture. In Cox single-factor analysis, when taking the time for occurrence of postmenopausal OP as the outcome variable, average age (RR = 1. 083, P = 0. 003 ) , whether menopause (RR = 5. 462, P = 0. 004), average menopausal year (RR = 1. 060, P = 0. 010) , menopausal year ≤10 years (RR =4. 890,P =0. 008), menopausal year >10 year (RR =7. 720,P = 0. 001) , delivery times ≤3 times (RR =5. 870, P =0. 003), dizziness (RR =3. 037, P =0. 001) , spasm of lower limbs (RR =2. 315, P =0. 003) , reduced bone mass in bone mass density (BMD) diagnosis (RR = 2. 376, P =0. 008) , β >0 and RR >1 in BMD diagnosis (RR =2. 801 ,P =0. 013) indicated they were risk factors for postmenopausal OP fracture. When taking BMD diagnosis, age, menopausal year, delivery times, dizziness, and spasm of lower limbs in multiple-factor analysis, menopausal year <10 years (RR =3. 257,P =0. 032) and dizziness (RR =2. 655,P =0. 005) were associated variables. Conclusion Dizziness and menopausal years were most important factors of OP fracture, and dizziness could be taken as symptoms of CM in early predicting occurrence of OP fracture.