Prior to the advent of mesh, tissue-based repairs were the mainstay of herniorrhaphy. These included such popular techniques as those described by Shouldice, Bassini, and McVay. The introduction of mesh-based inguinal hernia repair, which is now considered the standard of care in the USA, has not obviated the need for tissue repair. In modern times, the use of non-mesh tissue-based inguinal hernia repair is applied in a tailored fashion to some young adults and women, and in situations where mesh may be less desirable, such as contaminated or infected surgical sites and in patients with mesh-related for chronic pain or mesh implant illness (Sharma et al., Hernia 22(6):953–959, 2018). All tissue repairs for inguinal hernias are performed in open fashion and almost all via the anterior approach. The posterior approach to tissue-based inguinal hernia repair is not commonly performed but has been described by Nyhus and Condon as the iliopubic tract (IPT) repair (Nyhus, Hernia 7(2):63–67, 2003). We reincarnated the IPT repair using a minimally invasive posterior approach. Using the robotic platform, the robotic iliopubic tract repair (r-IPT) is a minimally invasive option to offer tissue-based inguinal hernia repair. The r-IPT repair can be included while contemplating a tailored approach for inguinal hernia repair (The HerniaSurge Group, Hernia 22(1):1–165, 2018). Patient selection and knowledge of anatomy is key to the success of this operation. The repair is best applied in low-risk patients with small indirect or direct inguinal hernias. In many situations, the patients may have a relative contraindication to mesh or a desire for a minimally invasive approach. These include patients requiring repair in a contaminated field, those at higher than average risk for mesh-related chronic pain or mesh implant illness (Sharma et al., Hernia 22(6):953–959, 2018). As with all tissue repairs, the r-IPT repair is a tension repair. It involves approximating the transversalis arch to the iliopubic tract. The repair is may be too tight and result in chronic pain or hernia recurrence in those who are obese or whose hernias are not small. To reduce the risk of chronic pain due to direct nerve injury or entrapment, a deep understanding of myopectineal neuroanatomy is critical to the success of the r-IPT. In this chapter, we review all the tips and tricks to assure best outcomes from r-IPT, starting with patient selection and ending in key technical pointers. With the right combination of patient selection and surgical technique, this repair has been shown to be safe and effective in offering a minimally invasive option for tissue-based inguinal hernia repair (Huynh et al., Hernia J Hernias Abdom Wall Surg 24(5):1041–1047, 2020).