Introduction: We aimed to compare early postoperative patient-reported outcomes between multiportal roboticassisted thoracoscopic surgery (M -RATS) and uniportal video-assisted thoracoscopic surgery (U-VATS) for nonsmall-cell lung cancer (NSCLC). Materials and methods: Symptom severity and functional status were measured using the Perioperative Symptom Assessment for Lung Surgery at pre-surgery, during postoperative hospitalisation, and within 4 weeks of discharge. A propensity score-matched (PSM) analysis of patients with NSCLC who were treated with M -RATS and U-VATS was performed. The symptom severity and daily functional status presented as proportion of moderate-to-severe scores on a 0 -10 -point scale, were compared using a generalised estimation equation model. Results: We enrolled 762 patients with NSCLC from a prospective cohort (CN-PRO-Lung 3), including 151 and 611 who underwent M -RATS and U-VATS, respectively, before PSM analysis. After 1:1 PSM, two groups of 148 patients each were created. Pain severity ( P = 0.019) and activity limitation ( P = 0.001) during hospitalisation were higher in the M -RATS group. However, no significant differences existed post-discharge in pain ( P = 0.383), cough ( P = 0.677), shortness of breath ( P = 0.526), disturbed sleep ( P = 0.525), drowsiness ( P = 0.304), fatigue ( P = 0.153), distress ( P = 0.893), walking difficulty ( P = 0.242), or activity limitation ( P = 0.513). M -RATS caused less intraoperative blood loss ( P = 0.013), more stations of dissected lymph nodes ( P = 0.001), more numbers of dissected lymph nodes ( P = 0.001), and less tube drainage on the first postoperative day ( P = 0.003) than U-VATS. Conclusion: M -RATS and U-VATS achieved comparable symptom burden and functional impairment after discharge. However, compared to U-VATS, M -RATS was associated with more severe pain and activity limitation in the short postoperative period. Trial registration number: ChiCTR2000033016.