Twelve studies, including 705 patients undergoing total hip arthroplasty (THA), were included in this systematic review and meta-analysis comparing the pericapsular nerve group (PENG) block versus no block, placebo/sham block, or other analgesic techniques such as fascia iliaca block (FIB) or periarticular infiltration (PAI). Pooled outcomes of interest included opioid consumption during the first 24 hours, postoperative pain scores at rest and during movement at various intervals, block performance time, sensory and motor assessments, quadriceps weakness, incidence of postoperative falls, time to first analgesic request, complications related to the block and opioids, patient satisfaction, length of stay in the post-anesthesia care unit (PACU) and hospital, and functional and quality of life outcomes. The pooled results demonstrated that the PENG block significantly decreased 24-hour oral morphine milligram equivalent consumption by a mean difference of 3.75 mg but had a modest reduction in dynamic pain score only at 24 hours postoperatively. The main findings suggest that while PENG block reduces opioid consumption, its impact on pain scores and other clinical outcomes may not be clinically significant enough to recommend it as the best practice for pain management in THA.