Eleven studies, encompassing 749 patients with midshaft clavicle fractures, were included in this systematic review and meta-analysis, which compared the outcomes of intramedullary fixation versus plate fixation in midshaft clavicle fractures. The outcomes of interest included the incidence of postoperative wound infection, surgical incision length, operative time, blood loss, and hospital stay. The analysis revealed that intramedullary fixation demonstrated a lower risk of postoperative wound infection (OR, 5.92; 95% CI, 2.46, 14.27 p < 0.0001), smaller surgical incisions (MD, 6.57; 95% CI, 4.90, 8.25 p < 0.0001), shorter operative time (MD, 17.09; 95% CI 10.42, 23.77 p < 0.0001), less blood loss (MD, 63.62; 95% CI, 55.84, 71.39 p < 0.0001), and a shorter hospital stay (MD, 1.05; 95% CI, 0.84, 1.25 p < 0.0001). However, no statistical significance was observed in the incidence of wound dehiscence.