Traumatic pubic symphysis diastases (PSD) are life-threatening injuries that often require operative fixation. The purpose of this review is to evaluate the outcomes of patients following various operative fixation techniques of these particular pelvic ring injuries. Specifically, we will analyze the role of: (1) surgical approach; (2) implant failure; and (3) fixation methods in treating traumatic PSD. They are typically fixed using the Pfannestiel approach, but a midline approach may be used in cases where this is not ideal. These fractures often have implant failure; however, studies have shown this does not impact clinical outcomes. Currently, the gold standard of fixation is multiple-hole plate fixation. There are a number of other surgical fixation methods such as two-hole plating or percutaneous fixation that may be considered as well. Future studies should focus on the long-term outcomes and efficacy of these new innovative techniques for fixation of traumatic PSD.