One randomized controlled trial (RCT) and 25 comparative cohort studies (n=14 prospective; 11 retrospective) were included in this meta-analysis to compared safety and efficacy outcomes between minimally invasive and open posterior lumbar fusion. The findings of this analysis demonstrated significantly favourable outcomes in terms of estimated blood loss, length of hospital stay, time to ambulation, Oswestry Disability Index scores, overall complication rate, and medical complication rate among groups who underwent minimally invasive surgery compared to open surgery, however, increased intraoperative fluoroscopy use was also noted. Outcomes which did not significantly differ between minimally invasive and open posterior lumbar fusion were operative time, VAS back and leg pain, rates of intraoperative dural tear, infection, and union rates.