The objective of this meta-analysis was to compare the fixation outcome of the Gamma nail and dynamic hip screw (DHS) in treating peritrochanteric fractures. Relevant randomised controlled studies were included, and the search strategy followed the requirements of the Cochrane Library Handbook. Methodological quality was assessed and data were extracted independently. Seven studies involving 1,257 fractures were included which compared the effect of the Gamma nail and DHS. The results showed a higher rate of postoperative femoral shaft fracture with the Gamma nail compared to the DHS [relative risk (RR): 7.27, 95% confidence interval (CI): 2.83–18.70, P < 0.0001] but no statistical differences in wound infection (RR: 1.02, 95% CI: 0.56–1.86), mortality (RR: 1.00, 95% CI: 0.81–1.24), re-operation (RR: 1.64, 95% CI: 0.91–2.95) and walking independently after rehabilitation (RR: 0.89, 95% CI: 0.60–1.33). It seemed that there were no obvious advantages of the Gamma nail over the DHS in treating peritrochanteric fractures.