Robotic-assisted total knee arthroplasty (TKA) continues to generate interest, largely because the technology promises greater accuracy and consistency than manual techniques. Current randomized evidence, however, shows no clinically meaningful differences between robotic-assisted and conventional TKA across key outcomes such as knee scores, functional measures, or superficial infection rates. Some longer-term metrics, including WOMAC, favor robotics statistically, but none reach thresholds patients would actually feel. Radiographic alignment is often more precise with robotics, yet this hasn’t translated into better patient-reported outcomes. Emerging alignment philosophies—kinematic, restricted kinematic, and functional—may ultimately reveal where robotics adds real value, particularly as implant positioning becomes increasingly individualized.