Five randomized trials containing 964 patients undergoing orthopaedic surgery (knee or hip surgery) were included in this systematic review and meta-analysis comparing perioperative meloxicam (n=485) and postoperative meloxicam (n=479). The primary outcome of interest was post-operative pain on a Visual Analog Scale (VAS). Secondary outcomes of interest included patient global assessment (PGA) scores, patient-controlled analgesia, overall satisfaction, and adverse events. Significantly better pooled VAS pain scores at rest and during motion in the first 24 hours post-operation were observed in the perioperative group. Pooled patient-controlled analgesia at 24 hours and PGA scores up to 48 hours post-operation were significantly in favour of the perioperative group. Pooled risk of adverse events was similar between groups, with exception of nausea (direction of effect unclear).