Four randomized controlled trials (153 shoulders) comparing total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) for patients with glenohumeral osteoarthritis, were included in this meta-analysis. The purpose of this meta-analysis was to compare the two procedures in terms of functional outcomes, quality of life and the incidence of revision. Results after a minimum follow-up of two years indicated that TSA results in significantly better functional outcomes when compared to HA. In addition, there were no statistically significant differences between groups in the incidence of revision, quality of life, and the incidence of shoulder instability.