Seventeen randomized controlled trials including 1,730 patients with distal radius fractures were included in this systematic review and meta-analysis comparing nonsurgical versus surgical treatment. Pooled outcomes of interest included DASH scores, grip strength, radial inclination, radial length, volar tilt, and wrist range of motion parameters. Surgical treatment significantly improved grip strength and reduced DASH scores compared with nonsurgical treatment. Additionally, surgical treatment resulted in better radial inclination and wrist pronation/supination but did not show significant differences in wrist flexion, extension, or ulnar deviation. These findings suggest that surgical treatment may offer functional benefits in specific patient populations with distal radius fractures.