Seven studies (3 randomized controlled trials; 4 cohort studies) were included in this meta-analysis comparing tenodesis and tenotomy in the management of patients with lesions of the long head of the biceps tendon. Meta-analysis was performed on Constant score, complications, satisfaction, and operative time. Qualitative assessment was undertaken for postoperative range of motion. Tenodesis demonstrated higher postoperative Constant scores and lower rates of cramp pain and Popeye deformity, while no significant differences were observed in satisfaction or range of motion. Operative time was significantly shorter for tenotomy.