5 studies comprising of 979 obese patients were included in this systematic review and meta-analysis comparing robotic-assisted total knee arthroplasty (RA-TKA) with conventional total knee arthroplasty (C-TKA). Pooled outcomes included operative time, radiographic alignment, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and Knee Society Score (KSS) functional outcomes. The analysis demonstrated that RA-TKA was associated with significantly longer operative times but achieved more accurate postoperative hip-knee-ankle alignment compared with C-TKA. No significant differences were observed in functional or patient-reported outcomes. Overall, the findings suggest that robotic assistance improves alignment accuracy in obese patients but does not translate into superior short-term clinical outcomes.