Ten studies including 560 patients were included in this meta-analysis comparing surgical intervention and conservative therapy for the treatment of acute primary patellar dislocation. Outcomes of interest included pooled recurrent dislocation rate, subluxation rate, Kujala scores, Tegner activity scores, re-operation rate and patient satisfaction. Meta-analysis results revealed significantly different pooled recurrent dislocation rates in favour of the surgery group. Pooled Tegner activity scores were significantly different in favour of the conservative group. Pooled subluxation rate, Kujala scores, re-operation rate and patient satisfaction outcomes were not significantly different between the two groups.