Purpose <p>This study aimed to compare quality of life and functional outcomes in patients undergoing robotic-assisted versus manual total knee arthroplasty (TKA), and to identify key factors influencing these outcomes.</p> Methods <p>This cross-sectional comparative study included that 116 patients who underwent unilateral TKA 60 with robotic assistance and 56 with manual technique were included. Patients who were 18&#xa0;years of age or older, who did not have a diagnosis of psychiatric illness, and who underwent a single knee replacement surgery were included in the study. Data were collected using the EuroQol Five-Dimensional Five-Level (EQ-5D-5L), Oxford Knee Score (OKS) and a structured data collection form from patients who came to the outpatient clinic for follow-up at the sixth postoperative week. All patients in the groups were operated on by the same physicians and received standard perioperative care.</p> Results <p>A statistically significant difference was found in the educational level between the two groups (<i>p</i> &lt; 0.001), while other demographic characteristics were comparable (<i>p</i> &gt; 0.05). No significant difference was observed between groups in OKS, EQ-5D-5L index scores, or EQ-VAS at 6 weeks postoperatively (<i>p</i> &gt; 0.05). Regression analysis revealed that experiencing the postoperative problems of the patients was the strongest predictor of reduced OKS (<i>R</i>² = 0.160), EQ-5D-5L (Adjusted <i>R</i>² = 0.154), and EQ-VAS scores (<i>R</i>² = 0.168), regardless of the surgical technique.</p> Conclusions <p>There was no statistically significant difference in functional outcomes or quality of life between robotic-assisted and manual total knee arthroplasty. However, the postoperative problems of the patients emerged as a key determinant negatively influencing patient-reported outcomes across both groups.</p>