In the main event, Roman Reigns defeated Kevin Owens to retain the Undisputed WWE Universal Championship.

The event also saw the return of color commentator Pat McAfee, who joined Michael Cole and Corey Graves on commentary, Cody Rhodes, Edge, Beth Phoenix, Asuka, Chelsea Green and Nia Jax made returns, and Logan Paul made his first Royal Rumble appearance.

It is one of the promotion's five biggest events of the year, along with WrestleMania, SummerSlam, Survivor Series, and Money in the Bank, referred to as the "Big Five".

In addition to airing on pay-per-view worldwide, it was available to livestream on Peacock in the United States and the WWE Network in international markets.

[13] During an appearance on the WWE After The Bell podcast on January 4, 2023, Knight said the only thing he knew about the match was that it would essentially be a street fight "kind of in the dark".

[14] On the January 6 episode of SmackDown, commentator Michael Cole further stated that the match would be "anything goes" and could only be won via pinfall or submission, but nothing else was known.

[15] The two previously feuded over the Universal Championship only for Owens to constantly lose due to interference from members of The Bloodline, including their manager Paul Heyman—Owens and Reigns' last title match was at the 2021 Royal Rumble.

[13] The following week, Owens challenged Reigns for the Undisputed WWE Universal Championship at the Royal Rumble, which was made official.

Finn Bálor entered at #20 and teamed up with his fellow Judgment Day teammate, Dominik, to eliminate Gargano.

NXT commentator and WWE Hall of Famer Booker T entered at #21 as a surprise entrant and attacked Bàlor and Dominik, after which, he performed the Spin-a-roonie to appease the crowd, however, he was quickly eliminated by Gunther.

The brawl spilled to the entrance aisle, just as Austin Theory entered #25, until Rhea Ripley came out and attacked Edge.

Shortly afterwards, Gunther broke Rey Mysterio's record for the longest time spent in a traditional Royal Rumble match.

After The Undertaker (2007), John Cena (2008), Triple H (2016) and Brock Lesnar (2022), Rhodes became the fifth person to win the match from the #30 position.

Additionally, Gunther set a new record for longest time spent in a men's Royal Rumble match at 1:11:40 and the second #1 entrant after "Stone Cold" Steve Austin in 1999 to emerge as runner-up.

[23] This was Wyatt's last televised match, as he died on August 24 due to a heart attack, caused by a life-threatening illness.

Tegan Nox entered at #16 and dominated Damage CTRL who reentered the ring as they were not eliminated after brawling with Lynch earlier.

A returning Chelsea Green entered at #20 only for Ripley to eliminate her in five seconds, setting the record for shortest time spent in a women's Royal Rumble.

This win made Ripley the first woman to win the women's Royal Rumble match from the number one position (and the fourth person overall to do so), and saw her spend the longest time in a women's Rumble match at 1:01:08, beating Bianca Belair's previous record of 57 minutes and 10 seconds, until 2024's event, where Bayley would break Rhea's record and last 1:03:03.

[23] In the main event, Roman Reigns (accompanied by Paul Heyman and Sami Zayn) defended the Undisputed WWE Universal Championship against Kevin Owens.

Reigns, Jimmy, Sikoa, and Heyman headed up the entrance aisle while Owens and Zayn were laid out in the ring as the event came to an end.

The company reported that it was the biggest gate in Royal Rumble history, garnering more than US$7.7 million, more than 50% than the previous record set by the 2017 event.

The final segment featuring The Bloodline, particularly between Roman Reigns and Sami Zayn, generated over 20 million views across all of WWE's social media platforms.

[28] Brent Brookhouse of CBS Sports gave praise to the main event, giving it a grade of A+, stating that "there was so much to dig into in that match".

[29] Wade Keller of Pro Wrestling Torch gave the match 4 stars out of 5, and that the angle was "phenomenal" with a "perfect crowd response".

[34][35] Men's Royal Rumble match winner Cody Rhodes opened the following episode of Raw, setting his sights on Roman Reigns and the Undisputed WWE Universal Championship at WrestleMania 39.

During the match, The Judgment Day tried to help Bálor win, but Edge evened the odds, only to be attacked by Rhea Ripley.

The four Royal Rumble runner ups were automatically added to the match: Asuka and Nikki Cross from Raw and Raquel Rodriguez and Liv Morgan from SmackDown.

[37] Two weeks later, Lita and Lynch challenged Kai and Sky for the WWE Women's Tag Team Championship[39] and defeated them on the February 27 episode to win the titles thanks to a returning Trish Stratus taking out Bayley, who tried interfering.

[47] It was then confirmed that Owens and Zayn would face The Usos for the Undisputed WWE Tag Team Championship at WrestleMania 39.

[48] With women's Royal Rumble match winner Rhea Ripley choosing to challenge for the SmackDown Women's Championship, The Judgment Day (Ripley, Damian Priest, Dominik Mysterio, and Finn Bálor) began appearing on SmackDown, thus Dominik began tormenting his dad, Rey, again.