Five randomized controlled trials including a total of 146 patients with hip fractures were included in this systematic review and meta-analysis comparing a pericapsular nerve group block (PENGB) vs. a fascia iliaca compartment block (FICB). Pooled outcomes of interest included pain control effectiveness, opioid consumption, incidence of quadriceps muscle weakness, and incidence of postoperative nausea and vomiting (PONV). The results indicated that both PENGB and FICB provided comparable pain control and opioid consumption. However, PENGB significantly reduced the incidence of quadriceps muscle weakness without increasing PONV risk. The main findings suggest that PENGB is advantageous for maintaining motor function post-surgery, potentially leading to better postoperative mobility and recovery.