Compared to the laparoscopic approach, the robot-assisted treatment of hiatal hernias is associated with fewer postoperative recurrences, less postoperative pain and a shorter length of stay; the robot-assisted approach facilitates high mediastinal esophageal mobilization, prolongation measures such as Collis gastroplasty are rare, as is the risk of perforation. However, robot-assisted hiatal hernia repair requires a specific learning curve and a well-coordinated surgical team. In this chapter, the primary literature on robot-assisted hiatal hernia repair is presented and its implementation discussed; the most important diagnostic procedures, the main surgical steps and the postoperative course are briefly outlined. By the end of this chapter, the reader will have a comprehensive understanding of the current data supporting robotic-assisted hiatal hernia repair, as well as knowledge of the essential steps for the perioperative management of these complicated patients.