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Objective: To investigate the efficacy and complications that might be associated with pyrocarbon compared with silicone in patients undergoing joint replacement surgery. Methods: The full-text papers about the clinical efficacy of pyrocarbon and silicone were retrieved from multiple databases. Review Manager version 5.0 was adopted for meta-analysis and analyses of sensitivity and bias. Results: Ultimately, we studied 232 patients across eight studies that met the eligibility criteria. The meta-analysis suggested a significant difference between the pyrocarbon and silicone groups in terms of the Disabilities of the Arm, Shoulder, and Hand (DASH) score (standard mean difference (SMD) = 1.48; 95% CI [0.97, 1.99]; P = .009; P for Heterogeneity <0.00001; I 2 = 63%); Visual Analogue Score (VAS) (SMD = 1.68; 95% CI [1.36, 1.99]; P < .00001; P for heterogeneity = 0.01; I 2 = 61%), and the abnormal radiolucent line (RR = 6.66; 95% CI [3.19, 13.89]; P < .00001; P for heterogeneity = 0.87, I 2 = 0%); and ossification development (RR = 0.90; 95% CI [0.56, 1.44], P = .66; P for heterogeneity = 0.94, I 2 = 0%). Conclusion: This study showed that pyrocarbon might be an efficient material compared with silicone for joint replacement surgery, but resulted in poorer functional and pain outcomes compared with silicone.