[Objective] To evaluate the clinical efficacy of robot-assisted percutaneous cannulated screw fixation of femoral neck frac- tures. [Methods] A retrospective study was done on 68 patients who received percutaneous cannulated screw fixation of femoral neck frac- tures from November 2017 to May 2019. According to preoperative doctor- patient communication, 32 patients received robot- assisted screw placement, while the remaining 36 patients were treated with freehand screw placement. The documents regarding to perioperative pe- riod, follow-up and radiographs were compared between the two groups. [Results] The robot group proved significantly superior to the free- hand group in terms of operation time, intraoperative fluoroscopy times, guide pin positioning times and postoperative walking time (P＜ 0.05) . During the follow-up lasted for (31.4±6.8) months on a mean, the robot group had 1 case of nonunion and 3 cases of femoral head ne- crosis, whereas the freehand group had 2 cases of nonunion and 5 cases of femoral head necrosis. The robot group resumed full weight bear- ing activity significantly earlier than the freehand group (P＜0.05) . The Harris score, hip extension-flexion and internal-external rotation range of motions (ROMs) significantly increased in both groups over time (P＜0.05) , which in the robot group were significantly better than the freehand group at 1 and 3 months postoperatively (P＜0.05) , whereas became not statistically significant between the two groups at the latest follow-up (P＞0.05) . Radiographically, there was no significant difference in Garden index between the two groups (P＞0.05) , while the robot group was significantly superior to the freehand group in terms of the parallelism and dispersion of cannulated screw placement (P＜0.05) . However, there were no significant differences in neck-shaft angle and Tonnis grade for hip degeneration between the two groups at the corresponding time points (P＞0.05) . [Conclusion] Robot- assisted fixation of femoral neck fractures with cannulated screws does shorten the operation time, improve the accuracy of screw placement, and facilitate the early recovery of hip function.