Background: Osteoporosis is a disease of the skeleton, characterised by micro-architectural deterioration of bone tissue and loss of bone mass. The present study was conducted to assess alteration in the cross-sectional area (CSA) ratio of the paraspinal muscles following vertebral insufficiency fractures. Materials & Methods: 75 patients of vertebral insufficiency fractures of both genderswere divided into 3 groups based on the presence of vertebral insufficiency fractures. Group I was with no fractures, group II with 2 and group III with >2 fractures. All were subjected to MR scan. The cross-sectional area (CSA) and cross-sectional area ratio (CSAR) of the psoas and paraspinal muscles (multifidus) at the level of L4/5-disc space was calculated on axial-T2 MRI images. Results: Group I had 13 males and 12 females, group II had 14 males and 11 females and group III had 15 males and 10 females. The difference was non- significant (P> 0.05). The mean CSAR in group I was 2.54, in group II was 2.05 and in group III was 2.18. The difference was significant (P< 0.05). Conclusion: Vertebral insufficiency fractures in the elderly show significant association with atrophy in psoas and the multifidus group of muscles. They also affect the CSAR depending on the number of fractures.