Nine randomized trials or quasi-randomized controlled trials containing 563 patients with primary patellar dislocations were included in this meta-analysis to compare the rate of recurrence between conservative and surgical management options. The rate of redislocation, subluxation, overall instability, and subsequent surgery were assessed, as well as pain and functional measures. The results from this meta-analysis indicated that patients that underwent surgical intervention had a lower incidence of redislocation. Most clinical and functional outcomes measures were similar between conservative and surgical management, while patients who underwent surgical management were more likely to have minor complications. The overall quality of the included trials was moderate to low and included small numbers of patients indicating the need for further trials with larger sample sizes.