16 randomized or quasi-randomized trials were included in this meta-analysis. The purpose of this study was to determine the efficacy and safety of closed suction drainage systems in hip arthroplasty. Pooled data revealed no significant reduction in the incidence of wound infections or hematomas with the use of a drain, while persistent wound discharge and a higher incidence of blood transfusions were observed with drain use. The findings from this meta-analysis suggest there is insufficient data to support the routine use of closed suction drainage for hip arthroplasty, but further methodologically sound trials are required before a definitive conclusion can be made.