The aim of this study was to compare as to which treatment achieves better outcomes in the management of giant retinal tears (GRTs) - pars plana vitrectomy (PPV) alone or combined with scleral buckle (SB)? The Web of Science, PubMed, and Cochrane Library databases were searched from January 1, 1950 to October 1, 2020. Pooled odds ratios (ORs), 95% confidence intervals (CIs), heterogeneity, and publication bias were determined with Review Manager software. PPV combined with SB significantly decreased the risk of recurrent retinal detachment (RRD, OR = 0.39, 95% CI = 0.20-0.77, I2 = 35%, p = 0.006) in GRT management compared with PPV alone. However, the final anatomical success (OR = 0.74, 95% CI = 0.23-2.39, I2 = 0%, p = 0.61), final visual acuity (OR = 1.11, 95% CI = 0.48-2.58, I2=13%, p = 0.81), and risk factors of GRT ≥180° (OR = 0.43, 95% CI = 0.15-1.22, I2 = 0%, p = 0.11) were not significantly different between the two approaches. According to the final anatomical success, final visual acuity, and risk factors of GRT ≥180°, there were no significant differences between PPV combined with SB and PPV alone for the management of GRT in the current study, except in decreasing the risk of RRD. Key Words: Giant retinal tear, Pars plana vitrectomy, Scleral buckling, Recurrent retinal detachment.