: in the present study, an attempt was made to determine the diagnostic accuracy of physical examination findings compared to imaging methods for the diagnosis of midfacial and mandibular fractures by consensus of the results and comparison with meta-analyses. Method: In present systematic review and meta-analysis, information about midfacial and mandibular fractures in all articles published until the end of July 2023 through searching in databases PubMed, Scopus, Science Direct, ISI, Web of Knowledge, Elsevier, Wiley, and Embase and Google Scholar search engine were extracted using keywords and their combinations by two trained researchers independently. Data analysis was done using the fixed effects model in meta-analysis, by STATA (version 17); P-value less than 0.05 was considered significant. Result: A total of six studies were included in the meta-analysis process. Sensitivity and specificity of physical examination compared to CBCT to diagnosis tooth mobility or avulsion was 14.63% (ES: 95% CI, 14.26% to 15.01%) and 97.47% (ES: 95% CI, 97.10%% to 97.84%), respectively. Sensitivity and specificity of physical examination compared to CBCT to diagnosis malocclusion was 21.58% (ES: 95% CI, 21.32% to 21.84%) and 95.02% (ES: 95% CI, 94.76%% to 95.26%), respectively. Conclusion: Physical examination findings are not diagnostically accurate of tooth mobility or avulsion and malocclusion and require CBCT.