A systematic assessment of published randomized control trials comparing sutured versus mesh-augmented hiatus hernia (HH) repair was conducted for this meta-analysis. HH recurrence at short- and long-term follow-up was our primary outcome. Surgical complications, operative delays, dysphagia, and quality of life were secondary objectives. The researchers sought to find relevant studies comparing mesh-augmented versus sutured HH repair for a study. They searched Medline, Scopus (which included Embase), Cochrane Central Register of Controlled Trials, Web of Science, and PubMed. Meta-analysis was used to collect data and analyze it using odds ratios and mean differences with 95% CI. About 7 randomised control trials comparing mesh-augmented (nonabsorbable mesh: n=296; absorbable mesh: n=92) and sutured repair (n=347) were discovered. Short-term hernia recurrence (defined as 6–12 months, 10.1% mesh vs 15.5% sutured, P=0.22), long-term hernia recurrence (defined as 3–5 years, 30.7% mesh vs 31.3% sutured, P=0.69), functional outcomes, and patient satisfaction all had no significant differences. The mesh repair required a longer operation time (P=0.05, OR 2.33, 95% CI 0.03–24.69), the only statistically significant difference. Mesh repair for HH was ineffective when compared to sutured Hiatal closure. A suture-only technique was still an appropriate option because both procedures produced good and comparable clinical outcomes.