Five randomized controlled trials were included in this meta-analysis comparing adductor canal blockade (ACB) and peri-articular infiltration analgesia (PIA) for the relief of post-operative pain following total knee arthroplasty. The primary outcomes of interest were equivalent morphine consumption and pain at rest and during movement measured on a Visual Analog Scale (VAS). Secondary outcomes of interest included the timed up and go (TUG) test, quadriceps muscle strength, complications and length of stay. Results revealed significantly lower pooled morphine consumption in the ACB group compared to the PIA group. VAS pain at rest at 48 hours was significantly in favour of the PIA group. There were no significant differences between the two groups in all remaining outcomes.