Background <p>The increasing use of low-dose CT (LDCT) screening has significantly enhanced the detection of pulmonary nodules, particularly in early-stage lung cancer. However, diagnosing peripheral pulmonary nodules (PPNs) presents unique challenges due to their distal location, rendering traditional methods like CT-guided biopsy less effective and associated with higher complication risks. Robotic-assisted bronchoscopy (RAB) has emerged as a promising minimally invasive technology that offers improved diagnostic accuracy and safety.</p> Methods <p>This review explores recent advancements in RAB technology for PPN diagnosis, focusing on the integration of multimodal imaging innovations. These include shape-sensing technology, electromagnetic navigation bronchoscopy (ENB), radial endobronchial ultrasound (rEBUS), cone-beam CT (CBCT), and needle-based confocal laser endomicroscopy (nCLE). Additionally, advanced biopsy techniques such as transbronchial cryobiopsy (TBCB) are discussed for their contributions to improving diagnostic yield.</p> Results <p>The integration of multimodal imaging technologies has significantly enhanced the precision of navigation and biopsy, reducing the risk of complications associated with traditional methods. Comparative studies show that RAB achieves similar or superior diagnostic outcomes compared to conventional approaches, with improved lesion targeting and tissue sampling. The use of techniques like TBCB has further improved the diagnostic yield and quality of tissue samples.</p> Conclusions <p>RAB represents a safer and more accurate alternative to conventional biopsy methods for diagnosing peripheral pulmonary nodules. The combined use of advanced imaging and biopsy techniques has solidified RAB’s clinical utility, making it a promising tool for current and future developments in pulmonary nodule diagnosis.</p>