A total of 722 patients in 9 RCTs were included in this meta-analysis comparing the intervention of an infrapatellar fat pad (IPFP) resection to an IPFP preservation during total knee arthroplasty (TKA). The primary outcomes of interest included patellar tendon length (PTL), Insall-Salvati ratio (ISR), incidence of anterior knee pain (AKP), and Knee Society Scores (KSS). The secondary outcomes of interest included knee range of movement (ROM). PTL, incidence of AKP, and knee ROM were analyzed at both 6-months and 1-year follow-up, whilst KSS was measured only at 1-year follow-up. Pooled results demonstrated that all outcomes of interest were not significantly different, except for the PTL at 6-months (p=0001) and 1-year (p=0.001) follow-up which was significantly in favour of the preservation group.