Robotic-assisted bronchoscopy (RAB) has emerged as a promising advancement for diagnosing peripheral pulmonary lesions (PPLs), addressing limitations of conventional techniques such as electromagnetic navigation bronchoscopy (ENB) and radial endobronchial ultrasound (rEBUS). Current RAB platforms—Monarch™, Ion™, and Galaxy™—enhance diagnostic precision through improved flexibility, stability, and navigation. Procedurally, RAB is performed under general anesthesia with registration aligning preoperative CT to intraoperative anatomy. Navigation employs direct visualization, electromagnetic navigation, or shape-sensing, augmented by fluoroscopy and rEBUS for lesion confirmation. Emerging adjuncts like cone-beam CT (CBCT) and cryobiopsy improve diagnostic yield, particularly for small or challenging lesions. Meta-analyses report pooled diagnostic yields of 75–85% for RAB, surpassing traditional bronchoscopic methods (68.8%), with low complication rates (pneumothorax: 0.6–5.7%). Comparative studies show no significant yield differences between Ion (82.5%) and Monarch (75.8%). While RAB demonstrates efficacy and safety, further studies are needed to optimize platform-specific workflows, validate factors influencing yield (e.g., lesion size, tools), and explore therapeutic applications. RAB represents a transformative step in minimally invasive pulmonary diagnostics, with ongoing innovations poised to refine its role in precision medicine.