The proliferation of continuous Neural Radiance Field (NeRF) and 3D Gaussian Splatting (3DGS) has shifted the paradigm of 3D aerial reconstruction from relying solely on geometric stereo matching to inverse rendering optimization. However, while these emerging rendering-based frameworks excel in synthesizing photo-realistic novel views, their capability to extract accurate surfaces in complex aerial scenarios remains ambiguous compared to traditional methods. To establish a clearer understanding, this study presents a comprehensive evaluation of five representative frameworks spanning traditional Structure from Motion (SfM), purely Signed Distance Field (SDF) representations, unstructured 3D Gaussians, hybrid voxel-Gaussians, and strictly explicit sparse voxels. By systematically standardizing identical computational environments, inputs, and unified mesh-extraction pipelines on both real-world airborne LiDAR datasets and synthetic cityscapes, we assess their performance regarding visual fidelity, geometric accuracy, and resource efficiency. The experimental results reveal that while traditional MVS produces the highest overall geometric precision by strictly enforcing multi-view rigid geometry, it is prone to failures in texture-less regions. Among rendering-based representations, a fundamental trade-off exists: highly flexible, unstructured 3DGS achieve highest visual scores but degrade the underlying geometric surfaces; conversely, explicitly structured techniques demonstrate distinct superiority in regularizing topological coherence and floating artifact suppression. Furthermore, we observe that integrating structured voxels avoids the severe memory bottlenecks associated with extracting geometries from chaotic unorganized primitives. These empirical findings emphasize that for large-scale aerial photogrammetry, integrating explicit spatial structuralization into differentiable rendering pipelines is imperative for achieving scalable operations and bridging the geometric accuracy gap with traditional methods.