7 randomized control trials (RCTs) and quasi-RCTs comparing imageless navigation to traditional methods of total hip arthroplasty (THA) were included in this meta-analysis. The purpose of the study was to determine if imageless navigation improved placement of the acetabular cup compared to standard THA methods. Imageless navigation was found to have a significantly reduced risk of cup malplacement (placement outside the safe zone) and significantly fewer inclination/anteversion outliers compared to traditional methods. No significant difference in cup inclination was observed between groups, and while significantly less deviation from desired cup anteversion was observed in the imageless navigation group, no significant difference in total anteversion was found between groups. Imageless navigation was associated with significantly longer operative time.