One hundred and four patients undergoing total hip arthroplasty (THA) were randomized into either a robotic-assisted THA group (RAS, n=47) or a conventional THA group (CON, n=51). The primary outcome was the accuracy of acetabular cup placement within the "safe zone" (inclination: 30–45°; anteversion: 10–25°). Secondary outcomes included changes in Harris Hip Score (HHS), femoral offset, and leg length discrepancy (LLD). Outcomes were assessed at a minimum of 3 months postoperatively. Overall, the study revealed that the robotic-assisted system led to significantly higher acetabular cup placement accuracy. However, there were no significant differences in postoperative HHS improvements, femoral offset restoration, or LLD between the groups. These findings suggest that the seven-axis robotic-assisted THA system enhances acetabular cup positioning accuracy while maintaining similar functional outcomes compared to conventional THA.