Ureteropelvic junction obstruction (UPJO) represents a common condition in pediatric urology, typically diagnosed through antenatal ultrasonography (US) or later in childhood via symptoms like flank pain or Dietl’s crisis. While US remains the first-line diagnostic tool, dynamic scintigraphy (e.g., MAG-3) and MRI may further characterize the obstruction, particularly to identify crossing vessels. The Anderson–Hynes dismembered pyeloplasty remains the gold standard surgical approach, with success rates between 90 and 100%. Since the first pediatric laparoscopic pyeloplasty (LP) in 1995, minimally invasive approaches, though technically demanding, have gained popularity. In recent decades, robotic-assisted laparoscopic pyeloplasty (RALP) has revolutionized pediatric urology, offering improved ergonomics, 3D visualization, and technical precision, becoming the preferred method for patients over 10–15 kg, with success rates nearing 100%. This chapter details the technical aspects, patient preparation, surgical procedure, and postoperative management of RALP. A transperitoneal approach is preferred, with the patient in a semi-lateral supine position. Port placement is carefully planned to optimize ergonomics and minimize vessel injury, with three robotic arms and a dedicated bedside surgeon essential for procedural efficiency. The robot is side-docked, and dissection typically involves mobilization of the colon to access the ureter and kidney, avoiding the mesocolic window when possible. Surgical steps include identifying the obstruction, mobilizing the renal pelvis and ureter, and performing the anastomosis using fine sutures. A double-J (JJ) stent is routinely positioned to prevent postoperative strictures, with postoperative management involving early oral intake, careful catheter management, and stent removal 4–8 weeks after surgery. Key technical “tips and tricks” include the use of colored sutures, a suction device, and possibly the AirSeal® system to optimize the operative field. In heavier children, RALP is now considered the first-line approach where available, with laparoscopy reserved for centers lacking robotic systems. Comparative studies show similar success rates among open, laparoscopic, and robotic pyeloplasty but shorter hospital stays with minimally invasive techniques. Robotic pyeloplasty has firmly established itself as the future standard for treating UPJO in pediatric patients.