Objective To systematically summarize and compare results and related advantages of different methods in the management of adult mid-shaft clavicle fractures. Methods The data of adult midshaft clavicle fracture from 1989 to 2009 was retrieved. The database were included Cochrane Database,med & Ovid Medline, OTA, AAOS, High Wire Press, Springer Link, CBM, CNKI, WANFANG DATA and with hand-search journals in related fields. Internalizing randomized controlled trials and retrospective cohort studies which compared the operative and nonoperative treatment for adult mid-shaft clavicle fracture. Evaluating the quality of included studies and using the Rvaman 4.2 for Meta-Analysis. Results 5053 literatures had been reviewed. After screening, there were 8 studies brought into the review that included 519 patients.There were 5 studies which took union rate as observed indicator. The results had statistically significant (P＜0.00001). A total of 4 studies used malunion rate as indicator, the results had statistically significant (P ＜0.0001). A total of 4 researches selected satisfaction of patient as indicator, the results had statistically significant(P＜0.00001). A total of 5 studies selected symptoms of nerve stimulation as indicator, the results had statistically significant (P＜0.0001). A total of 4 studies selected residual pain as indicator, the results had no significant statistically difference (P=0.56). A total of 2 studies selected barriers of joint activities as indicator, the results had no significant statistically difference (P=0.25). A total of 2 researches used refracture as indicator, the results had no significant statistically difference (P＞O.05). Conclusion This study evaluation results shows that operation can be used as the first choice of treatment of adult midshaft clavicle fractures.