A total of nine studies and 631 patients were included in this meta-analysis comparing Total Hip Arthroplasty (THA) to Hemiarthoroplasty (HA) for treating displaced femoral neck fractures (DFNF) in the elderly (>75 years old). Primary outcomes of interest included rate of mortality, deep vein thrombosis, complications, infection, operative time, reoperation, dislocation, and erosion as well as blood loss, and functional outcomes (Harris Hip score). Secondary outcomes of interest consisted of length of stay in the hospital, peri-prosthetic fracture rate, Europol (EQ) index-5D score, and prosthesis loosening. The pooled results revealed that THA was associated with improved quality of life and functional outcomes, but was associated with longer operative time and a higher rate of dislocation. Limitations should be considered, including a small number of studies were analyzed in this meta-analysis. Further, the outcomes of blood loss and peri-prosthesis loosening were not analyzed or reported in the results.