Five studies containing a total of 454 patients with long head of the biceps pathology were included in this meta-analysis comparing tenodesis (n=227) and tenotomy (n=227). Pooled outcomes of interest included the Constant Murley Score (CMS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, pain on a visual analogue scale (VAS), postoperative strength, and Popeye’s deformity. Dichotomous outcomes were pooled into relative risk ratios (RR) whilst continuous outcomes were pooled into weighted mean differences (MD). Results of the meta-analysis revealed no significant differences in pooled CMS, ASES, VAS pain scores, or flexion strength between the tenotomy and tenodesis groups (p>0.05 for all). However, tenodesis patients were found to be 3.07 times less likely to develop Popeye's deformity compared to tenotomy patients (RR=3.07 [95%CI 1.87, 5.02], p<0.00001).