<p>This study aimed to evaluate the synergistic effects of robotic-assisted (RA) technology and Enhanced Recovery After Surgery (ERAS) protocols on the surgical quality and clinical outcomes of femoral neck fracture (FNF) fixation. A total of 226 patients who underwent cannulated compression screw fixation for FNF were retrospectively analyzed and categorized into four groups: Freehand surgery with Routine Orthopedic Care (FH + ROC, <i>n</i> = 60), Freehand surgery with ERAS (FH+ERAS, <i>n</i> = 57), Robot-assisted surgery with ROC (RA + ROC, <i>n</i> = 57), and RA+ERAS (<i>n</i> = 52). Perioperative data, radiological accuracy, pain scores, functional recovery, and complication rates were compared. The RA group demonstrated superior intraoperative performance, with significantly less blood loss, fewer fluoroscopy exposures, and fewer guide needle adjustments compared to the FH groups. Radiographic analysis confirmed that the RA group achieved the highest screw placement accuracy. Regarding clinical outcomes, both ERAS groups showed significantly lower postoperative VAS scores and complication rates compared to the ROC group. Notably, the RA+ERAS group achieved the optimal functional recovery, with the highest Harris Hip Scores and the shortest full weight-bearing time, significantly outperforming other groups. The combined application of RA and ERAS is a reliable method for treating FNFs with cannulated screws. It significantly outperforms FH and ROC in terms of screw placement accuracy, postoperative recovery, and functional recovery.</p>