In the past 20 years, robotic technology has advanced, offering wristed instrumentation and three-dimensional optics. Overcoming the limitations of straight stick laparoscopy has permitted minimally invasive pancreaticoduodenectomy (MIPD) to be accessible to more patients with faster perioperative recovery and a lower risk of conversion to an open approach. These salutary benefits are especially important in patients with pancreatico-biliary cancer, who benefit from a quicker recovery to acquire adjuvant therapy. MIPD by itself is not to be considered a noncomplex operation. However, as robotic hepatobiliary surgeons advance on the learning curve and attain proficiency in routine cases, the limitations of what MIPD can achieve continues to be pushed further, allowing for more complicated operations to be completed. Patients presenting with more complex anatomical challenges, who may prove prohibitively difficult even by an open approach, can be tackled by robotic technology permitting not only a successful resection but one by a minimally invasive approach. There has been a rise in patients with morbid obesity, those living longer after initial complex hepatobiliary procedures and those with vessel-involved aggressive pancreatic cancers. Hepatobiliary surgeons with proficiency in robotic MIPD may consider tackling these difficult cases to effect cure. This chapter reviews the pertinent points in the preoperative, intraoperative, and postoperative course of patients who undergo complex robotic pancreaticoduodenectomy.