Objective To compare the clinical effect of single-port robot-assisted vNOTES （RSP-vNOTES） with that of traditional vNOTES （T-vNOTES） in total hysterectomy. Methods The data of 90 patients who underwent vNOTES total hysterectomy in the Second Affiliated Hospital of Nanjing Medical University from January 2024 to July 2025 were retrospectively analyzed. Propensity score matching was used to match patients in the RSP-vNOTES group and the T-vNOTES group，resulting in 30 pairs （60 patients） included in the study.Compare and analyze the differences in surgical effects，total hospitalization cost and the operator’s subjective intensity of workload between the two groups of patients. Results There were no significant differences in the total operation time，postoperative 24 h pain score，first postoperative flatus time，CD gradeⅠ~Ⅱcomplication rate，or hospital stay between the two groups（P>0.05）. Compared with the T-vNOTES group，the RSP-vNOTES group had less intraoperative blood loss， less intraoperative fluid infusion （P<0.05），and less operating time of critical surgical steps（P<0.05），but higher total cost of hospitalization （P<0.05）. Compared with the T-vNOTES group，the RSP-vNOTES group had lower mental need，lower physical need，lower score in performance level and lower score in effort level （P<0.05）. Conclusions For experienced surgeons，both RSP-vNOTES total hysterectomy and T-vNOTES total hysterectomy are safe and feasible. Compared with T-vNOTES，RSP-vNOTES total hysterectomy does not increase the length of operation，and may be more efficient in the critical surgical steps of hysterectomy； it has less intraoperative blood loss and fluid infusion，less workload of the operator ，and can improve the comfort of the operation.