Aim: To compare the short- and long-term outcomes of robotic-assisted total knee arthroplasty (TKA) and conventional TKA in terms of functional recovery, radiographic alignment, patient satisfaction, and complication rates. Materials and Methods: This prospective comparative study included 120 patients undergoing TKA for primary osteoarthritis. Patients were divided into two groups: robotic-assisted TKA (n=60) and conventional TKA (n=60). Robotic-assisted TKA utilized a preoperative CT-based 3D plan for precise implant alignment, while conventional TKA followed standard manual techniques. Functional outcomes were assessed using the Knee Society Score (KSS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Radiographic alignment, patient satisfaction, and complication rates were also evaluated at 3 months, 6 months, and 1 year postoperatively. Statistical analyses included t-tests and chi-square tests, with a significance level of p < 0.05. Results: Baseline characteristics were similar between groups. Functional outcomes improved significantly in both groups, with the robotic-assisted group consistently outperforming the conventional group at all time points. At 1 year, the robotic-assisted group had a higher mean KSS (91.5 ± 6.2 vs. 85.7 ± 7.3; p < 0.001) and a lower WOMAC score (50.2 ± 6.3 vs. 55.8 ± 7.1; p < 0.01). Radiographic alignment was more accurate in the robotic-assisted group, with fewer alignment outliers (3.3% vs. 23.3%; p < 0.01). Patient satisfaction was significantly higher in the robotic-assisted group at both 6 months (8.6 ± 0.9 vs. 7.9 ± 1.1; p < 0.01) and 1 year (9.1 ± 0.7 vs. 8.4 ± 0.8; p < 0.01). Total complication rates were lower in the robotic-assisted group (5% vs. 20%; p = 0.01). Conclusion: Robotic-assisted TKA significantly improves functional outcomes, radiographic alignment, patient satisfaction, and reduces complication rates compared to conventional TKA. These findings highlight the precision and safety of robotic-assisted techniques, supporting their role in enhancing TKA outcomes.