Background: Foot injuries common in emergency rooms include metatarsal fractures. The base of the 5th metatarsal is the most frequent. Aim: To compare the clinical and radiological results of conservative therapy versus surgical treatment of the 5th metatarsal bone fracture base. PRISMA standards were used to conduct this electronic literature on four academic databases: the Cochrane Library, Excerpta Medica Database (Embase), and Medline/PubMed. Methods: This study found eight trials, involving a total of 405 individuals, 137 were surgically treated and 270 were treated in a non-operational way. Those in the non-operative group showed a substantially greater non-union fracture odds ratio (OR) and reported a protracted period of healing and lengthy time to return to sport. Results and conclusion: This systematic review and meta-analysis provides a level of evidence supporting the use of operational interventions to reduce non-union rates, union duration, sporting time, duration for return to normal daily activity and visual analogue scale score compared to non-operative interventions. Operational treatments also improved treatment result as measured by the American orthopaedic foot & ankle scale in order to manage the base fracture of the fifth metatarsal compared with non-operative interventions. Results from current meta-analyzes may have a broad impact on the development of orthopaedic emergency recommendations for best practise fracture treatment on the base of the fifth metatarsal.