5 randomized controlled trials comparing cervical disc arthroplasty (CDA) to anterior cervical discectomy and fusion (ACDF) were included in this meta-analysis. The purpose of this study was to compare these two treatment approaches with respect to rates of adjacent segment disease (ASD), pain, disability, and quality of life in the mid- to long-term. Pooled data revealed that rates of ASD were similar between groups. CDA yielded significantly more favourable results with respect to rates of re-operation and neurological success, as well as improvements in disability, neck and arm pain, and Short Form-36 physical component scores. Rates of heterotopic ossification (HO) ranged from 3.2%-17% in the CDA group and HO was not reported in any patient in the ACDF group.