Objective To systematically summarize the application and research progress of robot-assisted total knee arthroplasty (TKA) in the treatment of valgus knee from the perspective of precision medicine in recent years, so as to provide a reference for the clinical treatment of valgus knee. Methods Relevant domestic and foreign literature, including clinical studies and evidence-based evaluations regarding robot-assisted TKA versus conventional TKA for valgus knee, was reviewed. A systematic analysis was performed focusing on technical advantages, efficacy differences and existing controversies. Results Conventional TKA is limited by surgeons’ experiences, leading to insufficient accuracy in alignment correction, great challenges in soft tissue balance, and postoperative residual deformity. Robot-assisted TKA is significantly superior to conventional approaches in terms of alignment correction accuracy, joint function improvement, and reduction of postoperative complication rates, with confirmed short-term effectiveness. Nevertheless, controversies remain concerning the limitations of robot applicability, prolonged operation time and uncertain long-term effectiveness. Conclusion Robot-assisted TKA provides a precision-oriented therapeutic option for valgus knee with remarkable short-term effectiveness. Further large-sample studies with long-term follow-up are still required to verify its efficacy and facilitate its clinical popularization.