Data from 11 studies (n=734) (only one RCT) was pooled to investigate a superior modality of treating tibial fractures between minimally invasive percutaneous plates and intramedullary nailing. The evidence presented in this meta-analysis indicated that minimally invasive percutaneous plate fixation in adult patients suffering tibial fractures was superior to intramedullary nailing in terms of fracture healing time, delayed union, and pain. No significant difference between the two interventions was observed concerning rates of excellent and good Johner-Wruh score, reoperation, or other complications. However, these findings have come from low quality evidence and should be interpreted with caution. Further investigation into the use of minimally invasive percutaneous plate fixation is required.