Thoracolumbar burst fractures (TLBF) are commonly treated with anterior approaches or long-segment posterior fixation, which provide stability but increase surgical morbidity and sacrifice motion segments. Short-segment pedicle screw fixation (SSPSF) with transpedicular bone grafting (TBG) has been proposed as a less invasive and cost-effective alternative that preserves motion segments while allowing indirect decompression through ligamentotaxis; however, mid-term evidence from large series remains limited. This retrospective case series evaluated the clinical and radiological outcomes of SSPSF with TBG in TLBF. A total of 187 patients treated over a three-year period were included. All patients underwent SSPSF using six pedicle screws placed bilaterally into the fractured vertebra and adjacent levels, combined with autologous transpedicular bone grafting. Clinical outcomes were assessed using the Visual Analog Scale, American Spinal Injury Association impairment scale, and Oswestry Disability Index. Radiological parameters included local kyphotic angle (LKA), anterior vertebral height ratio (AVHR), spinal canal occupation rate (SCOR), correction loss, fusion status according to Bridwell criteria, and hardware failure. Data were collected preoperatively, postoperatively, and at final follow-up. The mean patient age was 38.4 years, with a mean TLICS of 5.5. Mean operative time was 91.7 minutes, and mean intraoperative blood loss was 138 mL. LKA improved from 29.3° ± 4.2° preoperatively to 7.1° ± 2.1° postoperatively and was maintained at 7.9° ± 1.9° at final follow-up. AVHR increased from 45.2% ± 5.6% to 88.9% ± 7.1% postoperatively and remained at 86.4% ± 2.8% at final follow-up. SCOR decreased from 57.8% ± 6.3% to 17.2% ± 4.9%, with a mean correction loss of 5.3°. Solid fusion (Bridwell grade I–II) was achieved in 87.7% of patients, while hardware failure occurred in 5.8%. The mean Oswestry Disability Index at final follow-up was 22.5%. Multivariate analysis identified older age and smoking as predictors of nonunion. SSPSF with TBG is a feasible and time-efficient technique providing favorable clinical and radiological outcomes in TLBF; however, hardware-related complications and nonunion risk factors highlight the importance of careful patient selection.