Six randomized controlled trials involving 338 patients with distal radius fractures (DRF) were included in this systematic review and meta-analysis comparing surgical treatment with arthroscopic assistance versus treatment without arthroscopy. Pooled outcomes of interest included Disabilities of the Arm, Shoulder, and Hand (DASH) scores, wrist range of motion, and radiological parameters like volar tilt and ulnar variance. The overall pooled results showed no significant difference in DASH scores or wrist motion between the groups, with considerable heterogeneity across studies. Radiological outcomes were not poolable. There is low-quality evidence suggesting that arthroscopic assistance does not provide clinically or statistically significant benefits in functional or radiological outcomes compared to non-arthroscopic methods. These findings indicate that despite its technical application, arthroscopic assistance may not enhance surgical outcomes for DRFs.