Background <p>Mediastinal lymphadenectomy represents an integral component of anatomic lung resection in the surgical treatment of non-small-cell lung cancer. These procedures are now routinely undertaken utilising minimally invasive approaches. The present study aimed to compare the radicality of mediastinal lymphadenectomy during uniportal video-assisted thoracoscopic surgery (uVATS) and robotic-assisted thoracoscopic surgery (RATS) for anatomical pulmonary resection.</p> Methods <p>This comparative study was undertaken at a university hospital between January 2020 and August 2025. We evaluated the radicality of mediastinal lymphadenectomy in two patient cohorts: those undergoing uniportal thoracoscopic resection and those undergoing robotic-assisted thoracoscopic resection. Radicality was assessed based on the number of lymph node stations retrieved from the eight stations corresponding to each hemithorax, enabling determination of the extent and completeness of lymphadenectomy.</p> Results <p>Two hundred patients were included in the analysis: 100 underwent uniportal thoracoscopic anatomic lung resection and 100 underwent robotic-assisted lung resection. A statistically significant difference was demonstrated in the number of lymph node stations retrieved between the groups, favouring RATS over uVATS in both hemithoraces—left: 7.2 versus 6.6 (<i>p</i> = 0.0035); right: 7.3 versus 6.4 (<i>p</i> &lt; 0.0001). The 30-day postoperative morbidity rate was 28% in the uVATS group and 32% in the RATS group, demonstrating no statistically significant difference (<i>p</i> = 0.5370). Overall mortality in the study population was 1.5%, with no significant difference between techniques (1.0% for uVATS versus 2.0% for RATS).</p> Conclusions <p>Robotic-assisted thoracoscopy enables a higher yield of mediastinal lymphadenectomy compared with uniportal video-assisted thoracoscopy, while maintaining comparable postoperative morbidity and mortality rates.</p>