Introduction and Hypothesis <p>This video illustrates the surgical repair of a vesicouterine fistula (VUF) via a transperitoneal, robot-assisted, uterus-sparing approach.</p> Methods <p>In this video, we present a VUF that occurred after a cesarean section. The patient presented 22&#xa0;years later with persistent hematuria. She underwent a uterus-sparing, robot-assisted repair via excision of the fistula tract. The uterus and bladder were closed in multiple layers with omental interposition.</p> Results <p>The patient tolerated the procedure well. A follow-up cystography confirmed the absence of defects or fistula recurrence. She has remained asymptomatic since the surgery.</p> Conclusions <p>Our video demonstrates the feasibility of vesicouterine fistula repair with uterine preservation using an exclusively robot-assisted transperitoneal approach with omental interposition, yielding excellent results.</p>