Seven studies including 584 patients with scoliosis were included in this systematic review and meta-analysis comparing robot-assisted pedicle screw placement vs. freehand techniques. Pooled outcomes of interest included the accuracy of screw placement, operative duration, intraoperative blood loss, length of hospital stay, and complication rates. Robot-assisted placement showed significantly higher rates of "clinically acceptable" screw placement (P < 0.0001) but no significant difference in “perfect” placement (P = 0.08). Robotic techniques resulted in longer operation times (P < 0.0001) but shorter hospital stays (P = 0.03). The main findings suggest that robot-assisted techniques improve clinically acceptable accuracy and reduce hospital stays, but at the cost of increased operative time.