Seven randomized controlled trials and 15 observational studies were included in this meta-analysis which compared outcomes of operative treatment and nonoperative treatment for proximal humeral fractures. Pooled analyses for functional outcome on the Constant-Murley score demonstrated no significant differences between operative and nonoperative groups. Data from observational studies suggested higher rates of major reintervention and avascular necrosis development among operative groups, though these findings were not reflected in data from randomized controlled trials.