Purpose of review <p>This review aims to provide an updated overview of robotic nipple-sparing mastectomy (R-NSM); including current evidence, consensus guidelines, surgical technique, and comparative outcomes. The purpose is to synthesize recent evidence on the oncologic safety, feasibility, and clinical application of R-NSM, while incorporating personal insights from a surgeon’s perspective.</p> Recent findings <p>Recent literature supports R-NSM as a safe and reproducible technique with oncologic outcomes comparable to conventional nipple-sparing mastectomy. Advances in robotic surgical ergonomics enhance visualization, precision, and nerve preservation. Reported benefits include reduced nipple necrosis, favorable complication rates, and improved patient satisfaction. Learning curve analyses indicate that operative proficiency can be achieved after a limited number of cases in experienced centers.</p> Summary <p>R-NSM represents a major advancement in oncoplastic breast surgery. Future research should refine patient selection, assess long-term outcomes, confirm oncological safety and enhance training pathways for broader clinical adoption. </p>