Objective: This study aims to compare the efficacy of platelet-rich plasma and corticosteroids in treating plantar fasciitis, focusing on pain relief, foot function, and plantar fascia thickness to identify the optimal treatment approach. Design: A comprehensive search of medical databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing an extensive keyword strategy. Inclusion criteria encompassed prospective randomized controlled trials involving adult patients with plantar fasciitis treated with local platelet-rich plasma or corticosteroid injections, specifically assessing outcomes such as the visual analog scale, American Orthopedic Foot and Ankle Society scores, and plantar fascia thickness. Results: The meta-analysis included 24 randomized controlled trials with 1653 participants. Platelet-rich plasma injections yielded significantly better visual analog scale scores compared to corticosteroid injections at 3 mos (P = 0.03) and 6 mos (P < 0.001), with no significant differences at 1 mo (P = 0.12) and 12 mos (P = 0.08). American Orthopedic Foot and Ankle Society scores demonstrated that platelet-rich plasma was superior to corticosteroid at 3 (P = 0.05), 6 (P < 0.001), and 12 mos (P < 0.001), with no significant differences at 1 mo (P = 0.31). Regarding plantar fascia thickness, there were no significant differences between platelet-rich plasma and corticosteroid at 1–1.5 mos (P = 0.18), 3 mos (P = 0.64), and 6 mos (P = 0.05). Conclusions: Platelet-rich plasma injections offer superior pain control compared to corticosteroids in the medium term (3–6 mos) but not in the short term or at 1 yr.