The present meta-analysis was designed to systematically evaluate the effect of cemented and uncemented hemiarthroplasty on femoral neck fractures in the elderly and its effect on intraoperative bleeding and postoperative complications. Pubmed, Embase, the Cochrane Library, CNKI and WANFANG databases were retrieved and retrieval time was from inception to February 2019. Operative time, intraoperative blood loss, length of hospital stay, postoperative complications and postoperative mortality were compared between cemented and uncemented hemiarthroplasty. RevMan 5.3 statistical software was used for analysis. A total of 16 randomized controlled trials were included, with a total of 2,384 patients undergoing hemiarthroplasty. The cemented group had a longer operation time [weighted mean difference (WMD)=7.07, 95% confidence interval (CI)=3.91-10.23, P<0.0001], but it had lower incidence of intraoperative and postoperative fracture around the prosthesis (OR=0.25, 95% CI=0.13-0.47, P<0.0001) and shorter length of hospital stay (WMD=-1.78, 95% CI=-13.38–0.17, P=0.03). There was no significant difference in pulmonary embolism, mortality, lower extremity deep vein thrombosis rate, joint dislocation rate, intraoperative blood loss and postoperative incidence of lung, urinary system and incision infection between the two groups. To summarize, compared with the uncemented group, the cemented group had long operation time and a high incidence of pulmonary embolism, but had an advantage in reducing the risk of periprosthetic fractures. In addition, cemented hemiarthroplasty did not increase the mortality rate, the rate of deep vein thrombosis in lower extremities, the rate of joint dislocation, intraoperative blood loss, and the incidence of postoperative pulmonary, urinary, and incision infections.Copyright: © Kong et al.