Minimally invasive surgery has become nowadays the standard of care for many general surgery procedures, but its adoption in pancreatic surgery, particularly pancreatoduodenectomy (PD), has faced challenges due to the complexity of the procedure. Recent technological advances, improving the laparoscopic instruments, along with the implementation of robotic platforms, favored an escalation of reports on minimally invasive PD (MIPD) worldwide. Studies comparing MIPD to open PD (OPD) show mixed results. High-volume centers report benefits such as reduced blood loss and shorter hospital stays, while few reports from low-volume centers indicate higher complication rates. Randomized clinical trials have shown comparable safety profiles between MIPD and OPD, though some report longer operative times and higher costs for MIPD. Oncological outcomes for pancreatic ductal adenocarcinoma (PDAC) show similar rates of R0 resection and lymph node harvest between MIPD and OPD, with some studies suggesting better survival outcomes with MIPD. International guidelines recommend MIPD as an alternative to OPD in high-volume centers by experienced surgeons, emphasizing the need for structured training and outcome monitoring. Despite mixed evidence, the trend towards MIPD, particularly robotic pancreaticoduodenectomy (RPD), continues to grow, underscoring the importance of ensuring patient safety and continued monitoring through registries.