Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are safe and effective minimally invasive spinal techniques for the treatment of osteoporotic and pathological vertebral fractures, which are widely used in clinical practice. Cement leakage is the most common complication, which can lead to serious consequences such as adjacent vertebral refracture, pulmonary or cerebral embolism and paraplegia. Clinically, bone cement can penetrate into different sites along different paths, form different morphologies, and present different clinical symptoms. Therefore, an impeccable classification of bone cement leakage is beneficial to study its incidence, risk factors and prevention and treatment measures. So far, domestic and foreign scholars have proposed a variety of bone cement leakage classifications and elucidated its clinical significance despite certain limitations, but no uniform standard is established. Therefore, this review summarizes various classification and risk factors of cement leakage and evaluates their clinical implications, aiming at providing a reference for further clinical studies.