<p>Robotic-assisted laparoscopic pyeloplasty (RALP) and conventional laparoscopic pyeloplasty (LP) are widely used surgical techniques for treating pediatric ureteropelvic junction obstruction (UPJO). However, the relative advantages of these approaches remain unclear, and previous meta-analyses have been limited by outdated data and heterogeneous patient populations. This study aims to provide an updated comparison of perioperative and postoperative outcomes between RALP and LP based on studies published in the past decade. We systematically searched PubMed, Scopus, Web of Science, and Google Scholar for studies from January 2015 to March 2025 comparing RALP and LP in pediatric patients. The key outcomes included operative time, hospital stay, stent placement, complications, follow-up duration, and surgical costs. Study quality was assessed using the Newcastle–Ottawa Scale, and data were analyzed with Review Manager 5.4. Heterogeneity was measured using the I² statistic. Four retrospective cohort studies involving pediatric patients were included. The baseline characteristics, including age, weight, and BMI, were comparable between the two surgical groups. No significant differences were observed in operative time, stent placement rate, complication rate, or follow-up duration. However, the RALP group showed a significantly shorter hospital stay compared to the LP group. The surgical costs were substantially higher for robotic procedures. The cost comparisons in this study reflect direct procedural expenses only; broader aspects of cost-effectiveness, such as hospital resource utilization and long-term outcomes were not evaluated. High heterogeneity was noted in several outcomes, potentially related to differences in surgical experience, hospital resources, and regional healthcare practices. RALP provides similar safety and operative time to LP, with the benefit of shorter hospitalization. Further large-scale studies are required to confirm these findings and evaluate cost-effectiveness.</p>