BACKGROUND Percutaneous kyphoplasty (PKP) has been widely used to treat vertebral compression fractures (VCFs). Bilateral percutaneous punctures are always performed to access the fractured vertebrae. However, the procedure has expensive clinical costs, especially the cost for the device, which creates a heavy financial burden for patients. MATERIAL AND METHODS Data from 49 patients who have single-level non-neoplastic vertebral compression fracture (VCF) were collected for 12 months after treated by PKP, including 21 cases that used bilateral puncture with single balloon (S group) and 28 cases that used bilateral puncture with double balloon (D group). We assessed the clinical (visual analogue scale, VAS) and radiological (vertebral height and kyphotic angle, KA) outcomes. Cost data (gross medical cost, cost for the device and cost for drugs) were obtained from the medical bill of each patient. RESULTS Baseline patient variables were similar between the two groups except the compensation (S group <D group). No severe cement leakage and only one adjacent-level fracture were observed during the follow-ups. Each group showed significant improvements in the VAS, anterior height (AH) of vertebral body and KA after PKP, while no significant differences were observed when the VAS, vertebral height, and KA at the same time were compared between the S group and the D group. Costs in the S group were significantly lower than those in the D group. CONCLUSIONS Both single balloon and double balloon bilateral puncture PKP are relatively safe and efficient in non-neoplastic VCFs. However, reuse of the balloon in PKP can decrease the costs.