Pediatric stone disease is relatively rare in developed countries, with the majority of cases managed nonsurgically through medical therapy, often accompanied by JJ stent placement. Extracorporeal shock wave lithotripsy (ESWL) is commonly adopted for older children, while percutaneous nephrolithotomy (PCNL) and ureterorenoscopy are employed when stone extraction becomes necessary. Approximately 10–15% of pediatric cases require surgical intervention, where robotic-assisted surgery (RAS) has emerged as a preferred approach, particularly in high-volume centers equipped with specialized materials and expertise. Preoperative planning includes comprehensive imaging, metabolic evaluation, and prophylactic antibiotics. Patient positioning varies by stone location, with semilateral decubitus for renal stones and supine positioning for bladder stones. Robotic port placement must account for pediatric anatomical constraints, ensuring adequate spacing for optimal instrument maneuverability. Robotic instruments are complemented by endourological devices, including flexible ureteroscopes and laser lithotripsy systems. For renal stones, the surgical approach involves transperitoneal access, identification, and removal of stones using endobags and, if necessary, intraoperative flexible ureteroscopy to detect residual stones. In cases of concomitant ureteropelvic junction obstruction (UPJO), reconstructive techniques are incorporated. Bladder stone management involves robotic cystolithotomy with stone extraction via retrieval bags and meticulous bladder wall reconstruction. Postoperative management focuses on early mobilization, catheter management, and short hospital stays, with JJ stent removal scheduled within 2–4 weeks. Pain and infection are effectively managed with standard protocols. Robotic-assisted approaches demonstrate advantages in complex cases, offering enhanced dexterity, precision, and three-dimensional visualization. Although evidence remains limited, current studies suggest RAS provides high stone clearance rates with fewer auxiliary procedures, particularly in cases involving large stone burdens, bilateral stones, failed previous interventions, or associated urinary tract anomalies like UPJO. Robotic nephroscopy with flexible ureteroscopy during surgery is recommended to optimize stone clearance. Retrieval of stone fragments using a retrieval bag minimizes the risk of fragment loss. Based on current experience, RAS represents a safe and effective strategy for managing complex pediatric stone disease, and it is suggested as the first-line option for selected cases requiring surgical intervention.