Robotic surgery (RS) is a rapidly growing field worldwide. It provides countless benefits, including an increase in accuracy, three-dimensional image with depth perception, fully articulated instruments, and enhanced ergonomics. Developing a robotic surgery program is a complex but conceivable task currently being carried out in numerous centers in the United States. This chapter focuses on describing the pillars of starting a robotics program. The three phases of robotic program development are adoption, operationalization, and standardization. The adopting stage encompasses all related to the initial engagement of leadership, basic training, and support. The operationalizing phase is where the learning curve takes place, complexity is escalated, cultural change is promoted, and data collection begins. Finally, during the standardizing period optimization is the priority from both the procedural standpoint and the economic perspective. While the path toward success is convoluted and cultural change is a long-term goal, the benefits of developing a robotic surgery program are undeniable, especially with the unavoidable and fast-paced development of technology.