Twelve randomized controlled trials including patients with various spinal disorders were included in this systematic review and meta-analysis comparing robotic-assisted pedicle screw placement versus freehand techniques. Pooled outcomes of interest included accuracy of pedicle screw placement, postoperative complication rates, intraoperative radiation exposure time, and duration of surgery. The results demonstrated significantly higher accuracy in pedicle screw placement with robotic assistance. Postoperative complication rates, intraoperative radiation exposure time, and duration of surgery were comparable between the two techniques. The main findings suggest that robotic-assisted pedicle screw placement improves accuracy without increasing complication rates, radiation exposure, or surgery duration.