8 randomized controlled trials comparing cervical disc arthroplasty (CDA) to anterior cervical discectomy and fusion (ACDF), for the treatment of symptomatic cervical disc disease (1-level or 2-level), were included. The purpose of this study was to assess the safety and efficacy of these procedures at a minimum of 48 months, through a quantitative analysis of available literature. The results indicated that patients receiving CDA displayed higher rates of overall success, Neck Disability Index success, neurological success, and lower rates of serious treatment-related adverse events and secondary procedures when compared to ACDF patients. Functional results, patient satisfaction and the incidence of superior adjacent level degeneration were significantly better in the CDA group as well.