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Objective: To evaluate the efficacy and safety of zoledronic acid for the pain caused by metastatic tumor of bone. Methods: 52 patients with metastatic tumor of bone were randomly divided into two groups. The zoledronic acid group received 4 mg zoledronic acid infusion for 30 minutes and the control group received 90 mg pamidronate infusion for 6 hours.Results: The effective rates in zoledronic acid group and control group were 73.08% and 69.23% respectively. No significant difference was observed between the two groups. The median pain relief onset at days 5 and 7, respectively, and no significant difference was observed. The ECOG scores on the 7th day after medication: the differences in the zoledronic acid group before and after medication and between the two groups were both significant (P ＜ 0.001 and P = 0.0448). The adverse reaction was no significant difference between the two groups. Conclusion: Zoledronic acid is efficient and safe in the treatment of pain caused by metastatic tumor of bone and it has low adverse reaction rate and convenient shorter using time.