Osteoporosis leads to an increased risk of vertebral compression fractures (VCFs). Most of them are spontaneous, which makes early diagnosis difficult. The aim of the study was to find parameters that distinguish osteoporotic women with and without vertebral compression fractures. A total of 437 women with postmenopausal osteoporosis were enrolled to the study. Based on the results of densitometric vertebral fracture assessment, patients were divided into 2 groups: with (n = 193) and without (n = 244) VCFs. Then selected anthropometric, laboratory, and densitometric parameters as well as questionnaire data were compared. The following distinguishing factors were found among patients with VCFs in comparison to patients without such fractures: older age- 73.93 years vs. 69.63 years [p(1) < 0.001, p(2) < 0.001], shorter height - 1.56 m vs. 1.58 m [p(4) < 0.001], lower value of glomerular filtration rate (GFR) according to Cockcroft-Gault formula - 58.22 mL/min. vs. 66.25 mL/min. [p(1) < 0.025, p(2) = 0.002], lower peripheral blood haemoglobin and serum albumin concentration (OR = 1.24, 95% CI: 1.02-1.51, p(5) = 0.03; OR = 2.29, 95% CI: 1.09-4.80, p(5) = 0.03, respectively), and higher 10-year risk of major osteoporotic fracture (FRAX MOF) -12.01% vs. 9.69% [p(1) < 0.01, p(2) < 0.001] and hip fracture (FRAX HIP) - 3.85% vs. 2.55% [p(1) < 0.01, p(2) < 0.001]. In addition, among patients with VCFs a greater severity of back pain was found in the 11-grade scale of pain intensity - 6.12 vs. 4.29 [p(1) < 0.001, p(2) < 0.001, p(3) < 0.001]. The bone mineral content (BMC) and bone mineral density (BMD) of the hip were lower in patients with VCFs - 25.25 vs. 26.2 g and 0.72 g/cm² vs. 0.75 g/cm², respectively [p(4) = 0.04 and p(4) < 0.001, respectively]. Patients with VCFs were characterised by greater back pain intensity, higher fracture risk according to the FRAX calculator, and lower values of the following: GFR according to Cockcroft-Gault formula, peripheral blood haemoglobin and serum albumin concentration, and BMD of the hip. Further studies are required to validate the FRAX calculator to assess not only the risk of future fractures but also unrecognised VCFs.