Anterior Cruciate Ligament (ACL) injury is a common sports-related injury. Although arthroscopic ACL reconstruction (ACLR) is the standard treatment, the success of the surgery is highly dependent on the precise placement of bone tunnels, with technical errors being one of the primary causes of surgical failure. To address the precision challenges of traditional surgery, robot-assisted surgery has been introduced into clinical practice as an emerging technology, aiming to reduce human error by enhancing operational accuracy and reproducibility. This review elaborated on the current status, existing problems and future research directions of robot-assisted ACLR. Current research reveals a core "precision-outcome" paradox: although studies ranging from cadaveric models to multicenter clinical trials have consistently confirmed that robotic systems achieve significantly higher precision in bone tunnel creation than traditional manual methods, this technical advantage has not translated into superior clinical functional outcomes or knee stability for patients in short- to mid-term follow-up. This phenomenon may stem from the combined influence of multiple factors, including the biological healing of the graft, the quality of postoperative rehabilitation, patient-specific variables, and the insensitivity of existing clinical assessment tools. These factors may play a more critical role in determining the final outcome than marginal improvements in precision. Furthermore, the widespread adoption of robotic technology is still hindered by practical issues such as high equipment costs, longer surgical times, and a lack of haptic feedback. Looking ahead, the future direction for robot-assisted ACLR is to evolve from a tool merely pursuing precision into a "smarter" clinical partner. Through the deep integration of artificial intelligence (AI), augmented reality (AR), and comprehensive management of the entire process including postoperative rehabilitation, it may ultimately bridge the gap between technical precision and clinical efficacy, delivering long-term, tangible benefits to patients.