[Objective] To explore and analyze the application value of robot-guided percutaneous pedicle screw placement in the pri- mary medical institution. [Methods] A total of 46 patients received internal fixation of thoracolumbar fracture in People's Hospital of Nan- chang County from September 2020 to September 2021. Based on preoperative patient-doctor communication, 22 patients underwent robot assisted pedicle screw placement, while the remaining 24 patients had pedicle screw placed by traditional free-hand technique. The clini- cal and image data were compared between the two groups. [Results] The robot group proved significantly superior to the free-hand group in terms of number of fluoroscopy and operation time (P＜0.05) . The two groups were followed up for 6~8 months, and there was no signifi- cant difference in the fracture healing time between the two groups (P＞0.05) . The VAS scores and ODI scores significantly reduced in both groups postoperatively (P＜0.05) , nevertheless there was no significant difference between the two groups at the corresponding time points (P＞0.05) . The robot group was significantly superior to the free-hand group in Gertzbein-Robbins scale of screw placement accuracy (P＜ 0.05) . The anterior vertebral height and local kyphotic Cobb angle of the injured vertebrae in the two groups were significantly improved af- ter operation (P＜0.05) , whereas which were not significantly different between the two groups at the corresponding time points (P＞0.05) . [Conclusion] The robot-assisted percutaneous pedicle screw insertion does reduce the number of fluoroscopy and operation time, improve the accuracy of screw placement, which has application value for primary hospitals.