Insufficient osteogenesis is greatly essential to osteoporosis. Bugu Shengsui Decoction, a compound formula for osteoporosis, has significant clinical effects in the treatment of osteoporosis. Yet the detailed mechanisms are unclear. In this study, we first evaluated the pharmacological effects of Bugu Shengsui Decoction on bone metabolism, bone mineral density, bone morphology and biomechanics in ovariectomized rats. It also clarified the promoting effect of Bugu Shengsui Decoction on the proliferation and differentiation of osteoblasts. Based on the above results, we conducted quantitative proteomics research and a series of validation experiments, the results showed that PI3K-AKT signaling pathway and targets, such as Fn1, Col1a1, Col1a2, Col6a1, Col6a2, Col6a3, Rac1, Hsp90ab1, Hsp90b1, Ywhaz and Gnb2, were most relevant to the anti-osteoporosis efficacy of BGSSD. Summarily, our discoveries certify that Bugu Shengsui Decoction is an effective treatment for osteoporosis via PI3K-AKT.