7 controlled clinical trials were included in this meta-analysis comparing functional outcomes and knee laxity measures between cross pins and interference screws for femoral fixation in anterior cruciate ligament reconstruction. Pooled results on patient-reported functional measures and manual knee laxity tests (Lachman, pivot shit) demonstrated no significant differences between fixation types. Analysis of instrumented side-to-side difference in anteroposterior knee translation demonstrated significantly lower AP translation among cross pin groups compared to interference screw groups.