A meta-analysis of 17 studies (13 different trials), including randomized and prospective controlled trial was performed, with a total of 1364 patients. The outcomes of interest included mortality at 1 month, 1 year, and overall, infection, dislocation, revision, function (Harris Hip Score (HHS)) and Health-Related Quality of Life (HRQoL, based on Short-Form (SF)-36). Subgroup analyses were performed looking at unipolar vs. bipolar HA, mean age < or > than 80 years, and follow-up < or > 4 years. The included studies assigned patients to total hip arthroplasty (THA) versus hemairthroplasty (HA) for displaced femoral neck fractures (Garden III and Garden IV). Follow-up ranged from1 to 13 years. There was no difference in overall mortality, 30-day mortality, or 1-year mortality. There was also no difference between the two groups in in terms of infection, revision rate, function, or HRQoL. There was a significantly lower rate of dislocation in the HA group compared to THA (RR 0.37, p < 0.0001). The only finding that changed with subgroup analysis was that dislocation rate was only different in the first four years of follow-up, but not in studies with longer follow-up.