10 studies (8 randomized and 2 quasi-randomized controlled trials) were included in this analysis comparing intramedullary nails and dynamic compression plates in the treatment of humeral shaft fractures. The results indicated that while fracture union, functional outcome, and rates of radial nerve injury and infection were similar between treatments, intramedullary nails were associated with higher incidences of intraoperative fracture communition, shoulder impingement, restricted range of motion, implant failure, and re-operation. The strength of these findings were limited by the low quality of evidence, as evaluated using the GRADE system.