Neck femur fractures are considered one of the most dangerous fractures due to their high mortality rate. Detecting the specific manners of the femoral neck fracture is fundamental for surgeons. Objective: The aim of the present study was to provide a better management for fracture neck femur. Methods: This study represents a meta-analysis of literatures that compare between two treatment modalities; Total Hip Arthroplasty (THA) versus Hemiarthroplasty (HA) in treatment of fracture neck femur. Results: The mean ages of both groups showed similar values with mean of 72.48 ± 7.95 years and 72.63 ± 8.91 years in THA and HA, respectively with statistically insignificant difference (p >0.05). Operation times were more significant in THA than HA group (p =0.032). Radiological outcomes of the two techniques; excellent results were more in THA than HA (p = 0.001), good results were similar in the two groups (p >0.05), fair and poor results were more in HA than THA (p <0.001). There are more incidences of complications in THA than HA. Conclusion: Total hip arthroplasty has been proved to provide better outcomes than hemiarthroplasty for a proximal femoral fracture at the follow-up periods, however, more complications detected in THA than HA that may be taken into account.