Seven randomized controlled trials were included in this systematic review and meta-analysis to compare functional outcome measures between patient-specific instrumentation and conventional instrumentation in total knee arthroplasty. Pooled outcomes included the Knee Society Knee Score, Knee Society Functional Score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) scores. Results demonstrated no significant differences between groups for any pooled outcome.