Robotic-assisted Heller’s cardiomyotomy represents an advanced and minimally invasive procedure for the surgical treatment of paediatric achalasia cardia, a rare disorder of oesophageal motility. This procedure is emerging as a valid alternative to the traditional laparoscopic approach as the robotic assistance offers enhanced dexterity and superior precision, resulting in improved surgical outcomes and benefits for patient recovery. The aim of this chapter is to outline the surgical technique adopted by our team focusing on its technical aspects, advantages and perioperative management. The surgical set-up includes strategic patient positioning in reverse Trendelenburg, optimal port placement and liver retraction to enhance the access to oesophageal hiatus. The circumferential dissection of the oesophagus and the creation of the myotomy using bipolar forceps or a monopolar hook are key procedural steps before proceeding to a careful exposure of the oesophageal and gastric mucosa, approximately 7 cm (5 cm oesophageal and 2 cm gastric). It is highlighted how the robotic system improves dissection accuracy during the myotomy, minimizing the risk of mucosal injury, known as the most common complication of the procedure. The chapter also illustrates the management of potential mucosal perforations and the use of an anterior fundoplication when indicated. Finally, early mobilization, a controlled advancement of diet and close follow-up to monitor recovery and prevent complications are emphasized postoperative care. In conclusion, based on our experience, it can be deduced that robotic-assisted Heller’s cardiomyotomy is a safe and effective option for children with achalasia, offering significant advantages over conventional laparoscopic techniques.