Abstract: Objective To analysis the efficacy of radiotherapy synchronous or sequential zoledronic acid on bone cancer. Methods Seventy-five patients were divided into two groups. The observation group containing 39 cases were treated with radiation therapy and zoledronic acid at the same time; the control group containing 36 cases were treated with phosphoric acid two weeks after the end of radiotherapy. Results The effective rate in the observation group and control group was 92.31% and 86.11%, respectively; and there were no statistically significant difference in the two groups (P>0.05). The average pain relief time in the observation group and control group was 7 and 10 days, respectively; and the average painless maintenance time was 65 and 55 days, respectively; and there were no statistically significant difference in the two groups (P>0.05). Conclusion Treatment of bone metastases using radiation synchronization or sequential zoledronic acid showed the similar efficacy and side-effects.