Five studies (3 RCTs, 1 Cohort, 1 Case-control) were included in this analysis comparing fixation with and without screws in cementless acetabular component in total hip arthroplasty. Studies were included if they provided data on reoperation rates, component migration, or the incidence of osteolysis, as these were the primary outcomes of concern. The studies conducted follow-ups between 2 and 5 years postoperatively. Pooled results indicated that there were no significant differences in the outcomes of interest between fixation with and without screws.