Total knee arthroplasty (TKA) has been around for decades and serves as a very successful procedure to alleviate pain and restore function in a knee with advanced degenerative joint disease. Over the years, there have been many advancements in surgical technique and even more so in implant design. One of the more recent technological breakthroughs in TKA is the use of a robotic-assisted arm for enhanced preoperative planning and intraoperative guidance with dynamic joint balancing and bone preparation. This video article outlines the operative technique used by the primary author in performing a posterior stabilizing TKA in a varus deformity degenerative knee using Mako robotic assistance.