The purpose of this Meta analysis study is to provide a good idea and characteristics about the optimal fixation methods for fracture shaft femur in children 5-14y of age based on the current evidence. Patients and Methods: An electronic research was performed in PubMed, Medline, Elsevier, Google scholar and Cochrane Library database to identify the relevant literatures that published until 20 May 2020. By using RevMAN5.4 software the data of operative, postoperative, follow up and the reported complicationswas analyzed for the meta-analysis. Results:the pooled data showed a statistically significant difference in Operative Time, Estimated Blood Loss, Union Time and Fracture Angulation. Conclusion: According to the pooled data results we suggest the use of flexible nails with stable femoral shaft fractures in school age children, due to the minimally invasive technique, early union and weight bearing. In other hand using plate fixation is more stable and has lower rate of fracture mal alignment more than retrograde flexible nail and can be use with the unstable fractures due to the rigid fixation.