Kyphoplasty is an accepted therapeutic modality for the treatment of painful osteoporotic vertebral compression fractures. Complication rates are reported between 1% and 3% for osteoporotic fractures. Most previously reported complications, however, have occurred perioperatively. In this article, we report a case in which balloon kyphoplasty was performed as described by manufacturer guidelines. Four weeks after a successful kyphoplasty, the patient presented with a painful split vertebral fracture with anterior deformity at the same level where the kyphoplasty was initially performed. A recurrent fracture at the same level of a previous successful kyphoplasty may be considered in the differential diagnosis of a patient who presents with new pain at a similar level.