BACKGROUND: Robotic mitral valve surgery has evolved and matured into a safe and reproducible procedure at multiple worldwide centers of excellence. METHODS: History of robotic mitral valve repair is reviewed. Current results and recent advances are discussed. RESULTS: Multiple trials have demonstrated that surgical outcomes for robotic mitral valve repair meet or exceed the results of conventional operations, but long-term studies are required. Patients undergoing robotic mitral valve repair experience improved quality of life and faster return to full activity compared to sternotomy patients. Although operative costs may be higher than sternotomy procedures, total hospital costs may be equivalent and societal costs are probably reduced. CONCLUSIONS: Continued technological and procedural advances extend the benefits of robotic surgery to a larger patient population.