Data from 7 RCTs, including a total of 521 patients, was pooled to compare lateral fixation for supracondylar humerus fractures in children against crossed medial and lateral pinning. Analysis between the two techniques was evaluated based on risk of iatrogenic ulnar nerve injury, radiographic outcomes, function and other surgical complications. The evidence presented in this meta-analysis demonstrates that lateral pinning presents with reduced risk of iatrogenic ulnar nerve injury compared to crossed medial and lateral pinning. No differences were apparent between techniques for radiographic outcomes, function or other surgical complications.