[Objective]To evaluate the clinical efficacy of surgical and non-operative treatment of humeral shaft fractures. [Methods]The literatures about the comparison of non-operative treatment and surgical treatment of humeral shaft fracture were searched in the database of Pubmed, Embase, The Cochrane library, Web of science, SinoMed, China knowledge Network, Wanfang and VIP from January 2021, and the literatures were screened and extracted according to the inclusion and exclusion criteria. The outcome indexes and complications were meta-analyzed by Revman5.4 software. [Results]A total of 18 articles were included, of which 4 were randomized controlled trials. A total of 2218 patients were included, including operation group (n = 1278) and non-operation group (n = 940). Meta-analysis showed that the bone nonunion rate, reoperation rate, fracture deformity healing rate and CMS score of non-operative treatment were higher than those of operative treatment（P＜0.05）, while the rates of secondary radial nerve injury and infection were lower than those of operative treatment（P＜0.05）. There was no significant difference in delayed healing rate, fracture healing time, DASH score and Mayo elbow function score between the two groups（P＞0.05）. [Conclusions]The clinical function of non-operative treatment is similar to that of surgical treatment of humeral shaft fracture. The incidence of nonunion in non-operative treatment is higher, but secondary radial nerve injury is significantly increased after surgical treatment.