This is a meta-analysis of ten randomized controlled trials comparing operative and non-operative treatment for primary patellar dislocation. A total of 510 patients were included, and outcomes were recurrence (at 24-44 months and 72-86 months), function (at 24-44 months) and revision rate (at 72-84 months). A subgroup analysis was also performed on patients < 16 years old (at 24-168 months). Overall, operative management was significantly favoured in terms of recurrent dislocation and function at 24-44 months. There was a trend favouring surgery for recurrence and revision at 72-86 months, though this was non-significant.