Robotic-assisted arthroplasty represents one of the most exciting frontiers in orthopaedic innovation, promising greater surgical precision and potentially longer implant survival. By enhancing alignment and accuracy, robotics is theorized to improve patient outcomes, yet evidence demonstrating superiority in patient-reported function remains limited. An analysis of 18 RCTs (3,122 patients) highlights THINK Surgical as the leading research contributor, with most studies originating from the UK and Asia. Meta-analysis of robotic versus conventional total knee arthroplasty shows modest short-term functional gains, though clinical significance is uncertain. Importantly, cost-effectiveness data suggest robotics may be viable in high-volume centres by reducing revision and post-acute care costs. With only 20 ongoing registered trials—most in the U.S.—this remains an underserved but rapidly evolving research area, where stronger evidence could determine whether robotics becomes the standard in arthroplasty.