9 studies were included in this meta-analysis (5 RCTs and 4 quasi RCTs) to compare the outcomes of total hip arthroplasty with hemiarthroplasty in the treatment of displaced femoral neck fracture in elderly patients. A total of 1208 patients were identified from the 9 studies, with follow-up ranging from 12-156 months. Results of the analysis indicated that the use of total hip arthroplasty treatment had reduced pain and reoperation rates, but increased in rate of dislocation when compared to hemiarthroplasty. The two treatments did not differ in mortality and incidence of infection.