Sixty-five patients undergoing total hip arthroplasty for end-stage hip disease were randomized to receive either whole-process robotic assisted THA (RA-THA; n=31) or conventional THA (C-THA; n=34). The primary outcome of interest was femoral stem-related radiographic outcomes. Secondary outcomes included femoral side complications (notably subsidence and leg length discrepancy), clinical hip function scores (Harris Hip Score and Forgotten Joint Score-12), and operative time. Outcomes were assessed immediately, at 6 months, and at 18 months postoperatively. Overall, the results of the study revealed that RA-THA led to significantly better radiographic alignment (e.g., higher canal fill ratio at B1, more neutral stem alignment) and reduced femoral side complications such as subsidence and leg length discrepancy, though clinical outcomes did not differ between groups. The findings suggest that the robotic system improves surgical precision and may lower early complication risks, despite not enhancing short-term clinical function.