8 randomized controlled trials (n=983) were included in this meta-analysis comparing outcomes between total hip arthroplasty and hemiarthroplasty in elderly patients. Results indicated significantly higher Harris Hip scores and a significantly lower risk of revision in the total hip arthroplasty group when compared to hemiarthroplasty. There was, however, a trend towards a higher rate of dislocation for total hip arthroplasty, although not statistically significant. The most common complication requiring revision surgery was acetabular erosion. As a whole, total hip arthroplasty appeared to be favoured over hemiarthroplasty in this population.