Introduction: Total knee replacement (TKR) surgery is a standard treatment for end-stage knee osteoarthritis, but conventional techniques have limitations in accuracy and alignment. Robotic assisted TKR has emerged as a promising solution to improve surgical precision and outcomes. Methods: A prospective cohort study of 30 patients undergoing primary TKR, with 12 receiving robotic-assisted TKR and 18 undergoing conventional TKR. Surgical outcomes, functional measures, and patient satisfaction were assessed at multiple follow-up intervals. Results: Robotic-assisted TKR demonstrated superior accuracy in implant positioning and alignment compared to conventional TKR. Functional outcomes, as measured by knee society scores, were significantly higher in the robotic-assisted group at both 3 months and 1 year postoperatively. Patient-reported pain levels were also lower in the robotic-assisted group throughout the postoperative period. Moreover, satisfaction rates were markedly higher among patients who underwent robotic-assisted TKR compared to those who received conventional surgery. Conclusion: Robotic precision in TKR surgery offers significant advantages over conventional techniques, including improved surgical accuracy, alignment, functional outcomes, and patient satisfaction. These findings underscore the potential of robotic-assisted TKR to revolutionize total knee replacement surgery and enhance patient care.