Ten studies (randomized and quasi-randomized controlled trials) were included in this meta-analysis to compare functional outcome, adverse events, and operative time between intramedullary nailing and open reduction and internal plate fixation for displaced midshaft clavicle fractures. Results demonstrated no significant difference in functional outcome beyond 12 months between the two fixation methods. Plating was associated with a non-significant increase in the incidence of treatment failure requiring surgical intervention and was associated with a significant increase in the incidence of adverse events not requiring surgical intervention. Operative time was significantly shorter with intramedullary nailing compared to plating.