12 randomized controlled trials (788 patients) comparing the use of a minimally invasive medial midvastus approach (MMV-TKA) versus the standard medial parapatellar total knee arthroplasty (MP-TKA) were included in this systematic review and meta-analysis. Outcomes of interest included the Knee Society Score (KSS), knee pain on a Visual Analog Scale (VAS), knee function on a Normalized Function Scale, knee range of motion (ROM), time to straight leg activity, incidence of loose outboard support belt use, operative time, length of stay, blood loss, and incidence of postoperative complications. KSS scores, VAS pain scores, and knee joint flexural activity at 3 months, and days of straight leg raises were significantly better in the MMV-TKA group. Operative time was significantly shorter in the MP-TKA group. All other outcomes at all timepoints were similar between the two groups.