The Mitrofanoff principle, introduced in 1980, is based on the use of the appendix as a conduit between the bladder and the abdominal wall to create a continent catheterizable urinary diversion. In recent years, robot-assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA) has become a valid and effective alternative to open surgery, especially in pediatric patients, considering the advantages of minimally invasive surgery. This chapter describes our surgical approach to RALMA, in particular technical details, perioperative management, and functional outcomes. The procedure is performed under general anesthesia with the patient in Trendelenburg position; antibiotic prophylaxis is required. After robotic port placement and docking, the appendix is mobilized with its mesentery preserved and then anastomosed to the bladder via a 4-cm submucosal tunnel created in the posterior bladder wall; the distal appendix is exteriorized through the umbilicus to form a continent stoma. Robotics offers significant advantages during the procedure, especially in preserving the appendiceal vasculature and creating a watertight anastomosis, due to the enhanced visualization, precision, and dexterity. Postoperative management includes maintaining a bladder catheter in place for 2 weeks, after which patients are instructed on how to perform clean intermittent catheterization (CIC). In conclusion, this chapter highlights how, in our experience, RALMA is a safe, reproducible, and effective technique for continent urinary diversion in children.