6 studies (5 randomized controlled trials, 1 clinical controlled trial) encompassing 298 patients were included in this meta-analysis with the purpose of comparing the efficacy and safety of unilateral versus bilateral pedicle screw fixation in minimally invasive lumbar interbody fusion for one-level degenerative lumbar spine disease. Unilateral pedicle screw fixation achieved significantly shorter operative time and reduced blood loss compared to bilateral screw fixation. However, VAS back pain, VAS leg pain, ODI scores, overall fusion rate, overall incidence of complications, and length of hospital stay were similar between uni- and bilateral pedicle screw fixation.